Symptoms of Anxiety in Children: What Should I Watch For?

Lauren Trittin, MS, LMFTA

It’s no secret that anxiety rates are increasing across the board, including those of children, and for parents, this can become a major concern. The latest statistics on child mental health state that 7% of children 12 and younger are now being diagnosed with anxiety disorders (Centers for Disease Control and Prevention, 2019) and as many as 30% of children are impacted by anxiety issues at some point in their childhood (Child Mind Institute, 2019).

As your child’s protector, you carry a responsibility to promote their well-being. Often, when negative diagnoses or behavioral problems come about, parents feel immensely guilty, ashamed, and desperate to “fix” their child as quickly as possible. But what if you’re unsure what is going on with your child. Maybe they seem a little “off,” maybe you wonder if all kids have fears like your child’s, or maybe you’ve noticed them not socializing as much but don’t know if you should be concerned.

It can be frustrating reading diagnostic information about what types of anxiety disorders exist without any information provided as to what to look for in your child. However, knowing what anxiety disorders are, why they happen, what to look for, and what to do with what you find is not only empowering for you as a parent but also in your child’s best interest.

There are actually multiple types of anxiety disorders. Typically the time of onset of anxiety disorders is either in childhood or the early 20s. The broadest diagnosis is Generalized Anxiety Disorder, otherwise known as GAD.

For this diagnosis to be given, one must be experiencing anxiety that covers a number of subjects, such as school, work, and/or relationships and to a level that distresses the person and impairs functioning to some degree. Symptoms can include restlessness, fatigue, overthinking, considering worst case scenarios excessively, or experiencing trouble sleeping, along with other physical symptoms.

Another common anxiety disorder is Panic Disorder. This does not mean that if you have ever had a panic attack that you have Panic Disorder. In order to be diagnosed with Panic Disorder, one must experience a panic attack and then struggle with fear over having another one for at least a month after. This fear is combined with avoidant behaviors, such as avoiding exercise because it creates similar feelings of panic attacks (increased heart rate, rapid breathing, etc.).

Obsessive Compulsive Disorder is also an anxiety disorder. This involves experiencing intrusive thoughts that spark anxiety in a person because they believe the thoughts to be true. These are often fears about harm, violence, contamination, illness, and forbidden or perverse sexual thoughts (to name a few). Compulsions follow these thoughts in order to ease the anxiety these thoughts bring on, such as avoiding, reassuring, checking, and counting, among others.

Social anxiety is another anxiety disorder. This anxiety revolves around fearing what others may think of them or making a mistake and embarrassing themselves in front of other people. The anxiety leads to avoidant behavior and severe anxiety whenever she or he must interact with people.

Lastly, unlike GAD, phobias pertain to specific fears. The most frequently referenced phobia is arachnophobia, or fear of spiders. Another phobia is agoraphobia, which causes people to fear to leave their homes so much so that they rarely, if ever, do.

Because of the increase in anxiety rates, it’s also important to understand why they may occur. I would first argue that people are generally more aware of what mental health problems are and are becoming more comfortable reporting mental health concerns to providers. However, there is no arguing with the fact that anxiety rates are steadily on the rise.

There are multiple reasons for someone having or developing an anxiety disorder. The first and probably most overlooked reason is genetics. Some people are genetically predisposed to having an anxiety disorder. We often see lines of anxiety tracing back to parents and grandparents. Just like physical issues run in the family, so can mental health problems.

Life circumstances can also bring them on. For example, the Adverse Childhood Experiences test shows that the greater the number of “adverse” experiences a child faces, the more likely they will have physical and mental health difficulties. Some ACEs include abuse, neglect, divorced parents, domestic violence, substance abuse, and mental illness in the family. Other circumstances can also lead to increased anxiety, such as change of environment, loss of loved one, academic pressure, or bullying.

So how do you know if your child is struggling with anxiety? It might be easier for you to tell when anxiety is building in yourself or your other adult friends and family simply because you know what to look for. Anxiety tends to present differently in children than in adults, hence the struggle for parents to identify what is going on with their child.

Signs of Anxiety in Children

Here are some telltale signs you should consider getting your child assessed for anxiety by their primary care physician or a therapist:

Physical symptoms

This is the biggest red flag I look for as a clinician. If your child consistently complains of stomach aches, nausea, has digestive issues such as constipation, or headaches, and their doctor can find no reason for the symptoms, anxiety is likely the underlying cause. Start paying attention to whether there is a pattern to the symptoms. For example, if your child gets a tummy ache every time they have a test in school, it is likely anxiety.

Avoidant behavior

If your child starts avoiding things they used to enjoy, keep an eye on the situation. They may throw tantrums before school or going to a friend’s house or get weepy or angry when you mention a trip to the doctor. Additionally, they may stop participating in school. It’s important to identify the reason for the avoidance.

In the school example, they may be afraid of making a mistake and are choosing to not participate in class in order to avoid such a mistake. A caveat here is that sometimes introverted children get mistaken for anxious children.

If your child prefers having just a couple of close friends or is not always excited about big family gatherings, that does not necessarily mean they are dealing with anxiety. The key is to notice if they previously enjoyed the activity they are now avoiding.

Trouble focusing

If your child is so fidgety or restless that they struggle to pay attention to what you’re saying, or if they are having a hard time in class, this may be due to anxiety. Trouble focusing may also present itself as daydreaming. While some kids may just love dreaming of their after school snack, others may be trying to deal with racing thoughts.

Fears that don’t seem quite normal

This is especially true for OCD. If your child comes to you convinced they accidentally harmed someone or that God is angry at them, is petrified of making a mistake, or becomes distraught if their toys get moved out of order, they may be struggling with intrusive thoughts. In general, if your child seems to be worrying about things you don’t remember worrying about or is worrying about normal things but to a distressing extent, then you’ll want to move forward with assessing for anxiety.

Recent trauma

If your child has experienced a recent trauma, it is safe to say they will need some extra help to process it, especially if the trauma happened to them (such as directly experiencing or witnessing abuse). In this case, don’t wait for symptoms to present. Talk to their doctor or find a counselor who can help you and your child work through the trauma.

Any suicidal thoughts

If your child expresses having suicidal thoughts, draws pictures consistently about death, or states he or she wishes they were dead, hear these as calls for help and make an appointment with their doctor.

Treatment for Symptoms of Anxiety in Children

If any of these resonate with you about your child, you are likely wondering what to do now. The first step is to avoid blaming yourself. As stated, there are many reasons that anxiety develops. Rather, focus on the many ways you will be able to help your child with his or her anxiety disorder.

Contact their doctor. They will likely have a list of counselors to whom they can refer your child if they find they do believe your child has an anxiety disorder. Your child’s school counselor should also have names of counselors in the area. Once your child is in counseling, try to be as involved as possible. Developing secure attachments is the most effective way for a child to feel safe, thereby naturally decreasing anxiety, and therapy can be a great place to build such attachment.

Learn the coping mechanisms that are helpful along with your child and then help your child employ them when they feel anxious. Listen with patience and understanding when they express anxiety and strive to avoid any judgement. Remember, you might know their fears are irrational, but to them, their worries are big. Mostly, though, love them in it and through it.

If you are concerned about your child’s well-being, contact one of the counselors listed in the counselor directory today.

Resources:

Child Mind Institute, 2019. “Understanding Anxiety in Children and Teens.” https://childmind.org/our-impact/childrens-mental-health-report/2018report/

Centers for Disease Control and Prevention, 2019. “Data and Statistics on Children’s Mental Health.” https://www.cdc.gov/childrensmentalhealth/data.html.

Photos:
“Walking in the Field”, Courtesy of Artur Aldyrkhanov, Unsplash.com, CC0 License; “BFFs”, Courtesyof stem.T4L, Unsplash.com, CC0 License; “Cuddles from Mommy”, Courtesy of Jordan Whitt, Unsplash.com, CC0 License; “You Can’t See Me”, Courtesy of Caleb Woods, Unsplash.com, CC0 License

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