Are you worried about how anxiety may be impacting your own child's life? Anxiety is a normal emotion that everyone experiences from time to time, but frequent or persistent anxiety can interfere with our children's development in life. When a kids worry or child's fear that may be typical for young children does not get better over time, or if they start to interfere with your child's normal everyday activities like school, play, family time, or bedtime- it could be an indication of an anxiety disorder.
The prevalence of anxiety in children is estimated to be around 9-10%, has been increasing yearly, and is more common in girls than in boys (1).
Children with anxiety may experience physical and emotional symptoms and avoidance behaviors. If left untreated, it can progress and manifest into additional mental health concerns.
It is common for parents of anxious children to feel overwhelmed, frustrated, and confused about how to help. But the good news is that anxiety is a treatable condition. Children with anxiety can benefit from therapy, medication, and often a combination of both.
With the right support, children with anxiety can learn to manage their symptoms and lead full, happy, healthy lives. Parents, teachers, and other caretakers can play an essential role in helping children with anxiety by providing them with a safe and nurturing environment and working together to develop coping strategies to help their child manage anxiety. It's important to remember that it takes time for these strategies to be effective, so patience and understanding are key
This article aims to provide an overview of anxiety in children, including its explanation, impact, and potential treatment options. Keep in mind that we are NOT medical professionals and if you haven't already approached your child's pediatrician or therapist with concerns about your child's behavior or symptoms, that should be your next step. The goal here is to help parents and caregivers find the information and resources to help their children treat anxiety and lead happy healthy lives.
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Causes
A wide range of genetic and environmental factors, and commonly a combination of biological, environmental, and cognitive factors can cause anxiety.
Biological Factors
No doubt, genetics plays a role in the development of anxiety disorders (2). Children with a family history of anxiety disorders are more likely to develop anxiety. Any imbalances in brain chemistry, specifically in neurotransmitters like serotonin, can contribute to the development of anxiety disorders.
Environmental Factors
There's more than one way that environmental factors contribute to general anxiety and other mental disorders. One of the most well-known factors is trauma that a child encounters, like physical or emotional abuse, which can lead to the development of anxiety disorders.
Family dynamics, like a lack of support or conflict within the household, can also contribute to a child's anxiety. Many anxious kids also have family members with chronic anxiety.
Research suggests that anxious family members can contribute to the development and maintenance of anxiety, especially young children (3). Children with anxious parents or caregivers may be more likely to develop anxiety themselves, as they may learn anxious behaviors and have a heightened sensitivity to perceived threats or dangers because many children model behaviors they see in their everyday life. Additionally, anxious family members may unintentionally reinforce anxious behaviors in the child, leading to increased anxiety over time. It is important for caregivers to address their own anxiety and seek appropriate support and treatment managing anxiety in order to best support the child's mental health.
Stressful life events, the loss of a loved one, or a significant change in living circumstances can trigger anxiety in younger children too.
Cognitive Factors
A child's thinking patterns and beliefs can contribute to the development of anxiety. Children with negative thoughts and ideas, such as a fear of failure or a view that they are not good enough, are more likely to develop anxiety. Children with difficulty self-soothing, and managing their thoughts and emotions may also be more prone to develop negative coping strategies.
Types of Anxiety Disorders
Anxiety can come in many forms, including separation anxiety disorder, generalized anxiety disorder, social anxiety disorder, specific phobias, panic disorder, attacks, obsessive-compulsive disorder (OCD), and others.
As a parent, you should know that your children might have more than one cause leading to the psychological and behavioral symptoms of their anxiety disorder. It is essential to understand the individual child and the specific cause or causes of their anxiety to provide effective treatment. Overall, anxiety can be a complex issue for multiple reasons, but with proper evaluation and treatment, it can be managed and the symptoms reduced.
Signs and Symptoms Of Anxiety In Children
Undoubtedly, anxiety is a normal and natural emotion that everyone experiences from time to time, but it's the repeated, prolonged, or extreme anxiety that is concerning. Here are some primary symptoms of anxiety in kids:
Physical
Physical symptoms of anxiety in children may include things like stomachaches, headaches, fatigue, frequent bathroom urges, excessive crying, and muscle tension (4). It is possible that these symptoms are caused by the body's "fight or flight" response, activated when a child feels threatened or stressed. Children may also experience difficulty sleeping, or they may have nightmares or night sweats.
According to a post by Harvard Health Publishing, anxiety can cause a fight, flight, or freeze response in children which can result in symptoms like a racing or thumping heart, rapid breathing or trouble breathing, sweating, tense muscles, and a feeling of dread (5).
Behavioral
Anxiety in children may appear as avoidance, clinginess and frequent reassurance seeking, extreme fear, and/or aggression (6). They may avoid situations or activities they find stressful or overwhelming, like going to school or socializing with friends. On the other hand, when a child is anxious, they may become clingy and overly dependent on their parents or caregivers, seeking constant comfort and reassurance. In some cases, they exhibit aggressive behavior to express themselves.
Emotional
Several emotional symptoms are associated with anxiety, including intense fear of something, constant worry, irritability, and even anger. Children may feel anxious and afraid about a wide range of situations, including school, social interactions, and even have anxious feelings thinking about the future and bad things. In addition to these symptoms, children may also experience a sense of dread, which can be triggered by real or imagined threats. Sometimes, children may keep their worries to themselves, which can make it difficult for parents to recognize the symptoms.
Anxiety disorders can appear differently depending on the child's and adolescent's symptoms. For example, some children may only display physical symptoms, while others may only display behavioral or emotional symptoms. Children may exhibit physical symptoms but also have comorbid conditions such as depression or multiple anxiety disorders. The complexity of the issue is one key reason you need to seek professional help as soon as possible.
Impacts Of Anxiety On Children
The impact of anxiety on children can be significant, as it can affect their social interactions and overall well-being. Anxious children may struggle to make friends or maintain relationships. They may have more trouble sleeping, concentrating or difficulty falling asleep. They may even exhibit regressive behaviors or dangerous behaviors.
The child's academic and cognitive development can be affected by anxiety. They may find it hard to pay attention in class, remember information, and finish tasks. Poor grades and low self-esteem can result from this.
If left untreated, anxiety in children can have long-term effects on their mental health and overall well-being.
Treatment
Depending on the severity of the anxiety problem, children may need a combination of different treatment options. Medication, therapy, and lifestyle changes can help children manage their anxiety and improve their overall well-being. It's also essential that parents and caregivers are educated and involved in the child's treatment plan. If in school, it's a good idea to involve the child's teacher, so they're aware of the plan and how it may affect their interactions at school.
Anxiety in both younger children and older children can be treated in several ways, including:
Medications
Medication can be used to help manage the symptoms. The most commonly used medications for treating kids with severe anxiety are antidepressants and anti-anxiety medication.
Antidepressants, like selective serotonin reuptake inhibitors (SSRIs), can help to reduce feelings of worry, nervousness, and restlessness. They work by increasing the levels of serotonin, a chemical in the brain that helps regulate mood. It may take several weeks for SSRIs to start working, and they may cause nausea, headaches, and insomnia.
Anti-anxiety medication can also help reduce anxiety symptoms in children. These medications work by decreasing the activity of certain chemicals in the brain that can cause anxiety. Benzodiazepines can be helpful in the short term, but they may cause drowsiness and have the potential for addiction if used for an extended period (7).
Abrupt discontinuation of medications used to treat anxiety can cause withdrawal symptoms, like rebound anxiety, insomnia, flu-like symptoms and other uncomfortable physical sensations(8). A key reason it is so important to work with a healthcare provider to gradually taper off the medication when the time is appropriate.
Overall, while medication can be an effective treatment option, it should be used carefully and under the supervision of a healthcare provider to minimize the risk of adverse effects.
Medication should only be used in conjunction with therapy and under a doctor's or psychiatrist's guidance. Some drugs can effectively reduce anxiety symptoms, but it should not be considered the only or even a solo treatment option.
Parents should know that medication is not a one-size-fits-all solution, and it may take some time to find the proper medication and dosage for a child. The decision to use medication to treat the child should be made after a thorough evaluation by a mental health professional and a discussion with the child and their parents or caregivers.
It's also important to monitor the child for any side effects and adjust the medication accordingly.
Therapy
CBT
Cognitive behavioral therapy (CBT) and family therapy are commonly used to treat children's anxiety. CBT is a talk therapy that helps children understand how their thoughts, feelings, and behaviors are interconnected. That allows them to develop coping mechanisms for managing their anxiety (9).
Therapy As A Family
Family therapy can also be beneficial as it involves the whole family and helps to improve communication and understanding within the family.
A University of Connecticut Health study found that family therapy for families with parents diagnosed with anxiety can PREVENT children from being diagnosed with anxiety and that the therapy was significantly more successful than simply giving parents a handout that explained anxiety disorders (10).
Overall, therapy as a family can be an important and effective part of treating symptoms of anxiety in kids, as it can address both the individual child's needs and the family's functioning as a whole.
Play Therapy
Cognitive Behavioral Play Therapy has been shown to improve social anxiety disorder in children that have a stutter (11), and there have been multiple studies to prove that play therapy can reduce symptoms of anxiety for children who are hospitalized, but we couldn't find any definitive studies that discuss play therapy as a treatment for anxiety in kids that are not undergoing medical treatment.
However, there are many therapists and companies that support play therapy as a treatment for anxiety disorders based on their anecdotal evidence (12).
Lifestyle Changes
Regular exercise, relaxation techniques, and good sleep hygiene can make a huge difference in your children's lives.
Exercise has been shown to impact mood positively and can be a great way to help children manage their anxiety. It's recommended to get 60 minutes of exercise a day, especially if your child is dealing with anxiety.
Relaxation techniques like deep breathing and meditation can be helpful.
Maintaining a regular sleep schedule and developing healthy sleep habits can improve overall well-being and reduce anxiety symptoms.
Some children become anxious with a change in their daily routine. So, preparing your anxious child ahead of time for a change involves telling them what will happen and why (6).
It's essential to recognize that anxiety can be a chronic condition and require ongoing management. With the proper treatment, children can tackle their symptoms and improve their overall quality of life. It's essential to seek professional help if you suspect your child suffers from anxiety.
Resources for Parents and Caregivers:
https://www.mentalhealth.gov/talk/parents-caregivers
https://www.worrywisekids.org/
Book: Helping Your Anxious Child: A Step-By-Step Guide For Parents
Book: Freeing Your Child From Anxiety
Book: What to Do When You Worry Too Much: A Kid's Guide to Overcoming Anxiety
Book: Sometimes I'm Anxious: A Child's Guide to Overcoming Anxiety
Final words
As a parent, it can be difficult to see your child anxious, but with early recognition and appropriate treatment, anxiety in children can be effectively managed. If you suspect your child is experiencing anxiety, it is very important to seek help from a mental health professional that specializes in children's health. They will perform an evaluation and determine the best course of treatment, which may include therapy, medication, or a combination of both. Although we want you to take it seriously, please remember that children can learn to manage their anxiety and have full happy lives with proper support.
Sources:
1.) https://www.cdc.gov/childrensmentalhealth/features/anxiety-depression-children.html
2.) https://www.nimh.nih.gov/health/topics/anxiety-disorders
3.) https://pubmed.ncbi.nlm.nih.gov/11758699/ doi: 10.1016/s0005-7967(00)00107-8
4.) https://www.cdc.gov/childrensmentalhealth/depression.html
5.) https://www.health.harvard.edu/blog/anxiety-in-children-2018081414532
6.) https://www.nhs.uk/mental-health/children-and-young-adults/advice-for-parents/anxiety-in-children/
7.) https://pubmed.ncbi.nlm.nih.gov/6119192/
8.) https://www.health.harvard.edu/mind-and-mood/going-off-antidepressants
9.) https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral
11.) https://pubmed.ncbi.nlm.nih.gov/34106582/ doi: 10.1097/MD.0000000000024350
12.) https://www.tribecaplaytherapy.com/blog/2017/12/7/how-does-play-therapy-reduce-anxiety-in-children
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