Anxiety in Children and Adolescents: Information for Parents and Caregivers

Dylan is afraid of the dark. Tricia hates eating in front of others. Eric is nauseated and starts vomiting if he has to speak in front of the class. Fear and worry are very normal aspects of the lives of children and adults. However, if these worries become a concern because they significantly affect the daily functioning, then we talk about anxiety.

Parents may notice that their child seems nervous or fearful. This can be linked to a stressful event, such as playing in a room at school or writing an exam. In such situations, it is normal for a child to feel worried or nervous. It may even help the child memorize his text or study more for a test. However, it becomes problematic when children or teens often feel nervous or worried and have difficulty coping with a new situation or challenge. Rather than just feeling “nervous,” they are rather “anxious”.

Anxiety is defined as a feeling of worry or discomfort. When the level of anxiety is significant enough to interfere with the daily activities of a child or youth, it is refer to as an anxiety disorder. Anxiety disorder is a psychiatric condition that may require medical or psychological treatment.

What causes anxiety disorders?

Anxiety disorders have multiple and complex origins. It is likely that genes play a role in the occurrence of anxiety. However, home, neighborhood, school, and other environments can also contribute to anxiety.

For example, some babies or young children who live with too much stress can become anxious. Other children may “learn” to respond in bad manners because a parent or guardian shows signs of anxiety. In most children and young people, it is a mix of these causes that leads to anxiety disorder.

Frequency of anxiety disorders

Anxiety disorders are the most common psychiatric problems in children and adults. It is estimated that about 6-13% of children and adolescents have an anxiety disorder, with girls receiving this diagnosis more often than boys.

How long do they last?

Without treatment, some anxiety disorders that begin in childhood can last a lifetime, although they may occur periodically.

What is normal and what is it not?

Being nervous about a particular event, such as an exam, is normal. Avoid any situation that causes anxiety is not and may be that the child or adolescent has an anxiety disorder.

In some situations, anxiety may be normal for a younger child, but not for an older child. The young child who is upset when left alone with a babysitter for the first time is a good example. This separation anxiety is a normal reaction for a young child, but not for a teenager. When symptoms begin later in childhood or adolescence and continue for several weeks, then it may be helpful to consult a professional.

Types of anxiety disorders

Children and adolescents may have more than one type of anxiety disorder at a time. Some types of anxiety disorders are:

Separation anxiety disorder

Sometimes older children and teenagers are afraid to leave their parents. They may worry that something bad might happen to their parent (s) or other loved one. This is a problem only when there is no valid reason for this concern. These young people may have a separation anxiety disorder.

Children with Separation Anxiety Disorder may refuse to attend school or be unable to fall asleep without the presence of a parent. They can have nightmares in which they are lost or abducted. They may also have physical symptoms caused by fear, such as stomach upset, nausea or even vomiting .. A diagnosis of separation anxiety is made if the behavior is present for at least four weeks and the persistence of true Ongoing social or academic problems result.

Generalized anxiety disorder

It is a condition in which the child or adolescent has many concerns and fears. They have physical symptoms such as muscle tension, a feeling of restlessness, fatigue, difficulty concentrating or sleeping. Often children with this condition try to do everything perfectly and they need approval.

Social phobia

Social phobia is one of the most common teenage problems teens face today.  It involves worrying about social situations, such as going to school or talking in class. Symptoms may include sweating, redness or muscle tension.

People with this disorder usually try to control their symptoms by avoiding situations that scare them. Young people are often overly sensitive to criticism and have difficulty defending themselves. They may also suffer from low self-esteem, feel easily embarrassed, and be very embarrassed and shy.

Obsessive-compulsive disorder (OCD)

OCD symptoms usually begin in early childhood or adolescence. Children and young people with OCD have frequent, uncontrollable and excessive thoughts (obsessions) that often come to mind. They must then perform certain routines or rituals (compulsions) to try to get rid of thoughts. Children and adolescents with this disorder will often repeat certain behaviors to avoid an imagined result. For example, some people who are afraid of microbes will wash their hands repeatedly to avoid getting sick. These thoughts can also cause a lot of anxiety Obsessions and compulsions can take so much time that the young person cannot lead a normal life.

Panic disorder

This is a serious type of anxiety disorder. The panic attack in adolescents, and sometimes in children, is felt as excessive fear, or difficulty breathing with a high heart rate. They may also have tremors and dizziness and feel as if they will lose their head or even die. The teenager or the child may not want to go to school or leave the house because he is afraid that something terrible will happen to him. Frequent panic attacks may be an indication of a panic disorder.

Post-traumatic stress disorder (PTSD)

PTSD is rather rare in children. It usually includes a set of symptoms that occur after one or many episodes of severe emotional upheaval. Symptoms include bursts, muscle tension, exaggerated sensitivity to his surroundings (hyper vigilance), nightmares and other sleep problems.

Sometimes, children and young people with PTSD raise that they feel as if they are reliving the traumatic experience. These “flashbacks” often include intense memories of triggering events, such as physical, emotional or sexual abuse.

Selective mutism

It is a term used to describe the behavior of some children who do not speak in certain situations while they speak in others. Children with selective mutism have a particular concern about speech, but only in situations that cause them anxiety.

Some children may only talk to their parents, but not to other adults. When they know they will have to talk, these children can blush, lower their eyesight or withdraw. When they communicate in such situations, they can point fingers, make gestures or whisper rather than talk. Up to 2% of school-aged children may have symptoms of selective mutism. These usually appear when the child starts attending daycare or school. The symptoms may disappear as you get older, but a good number of children end up developing a social phobia.

Which treatments are effective?

Cognitive behavioral therapy is considered as the best treatment of choice. If an older child or adolescent does not response favorably to cognitive-behavioral therapy, medications can be apply for treatment.

Anti-anxiety medications such as selective serotonin reuptake inhibitors (drugs that help regulate brain chemicals) and cognitive behavioral therapy (CBT) have been shown to be effective in treating anxiety disorders in children.

What can parents do to help their children cope with their fears and anxieties?

  • Provide an unconditional validation. First, make sure your child feels comfortable expressing their fears, worries, or other painful feelings. Validate these concerns. Do not minimize them. If a child feels that he can come safely to an attentive adult with his worries, it helps him to feel deep inside him a little safer.
  • Be patient and reassuring. Talk to him and be positive about his ability to cope with situations that cause anxiety. Keep open the lines of communication.
  • Reward your child for good coping behaviors. Praise him for his “brave” behavior and for his successes, even partial ones. You need to focus on your child’s efforts to confront and manage their concerns.
  • Manage your own anxieties without allowing your own concerns to affect your child’s behavior. Be a role model for your child and show him how to act in everyday life without fear and anxiety.
  • Instead of avoiding the question that causes fear or anxiety, reinforce your child’s exposure to it. If your child is afraid of spiders, you could start reading a book about spiders. If your child is afraid to speak in front of a group, he or she might talk about his or her favorite toy at the next family meeting. Give your child opportunities to overcome his fear by reinforcing his exposure to what scares him and allowing him to record small victories.
  • Teach your child positive monologues. Like the little locomotive that could get there, teach your child to repeat a positive sentence that will help him overcome his fear. “I know I can do it” or “I’m brave and I’m not afraid” can help your child feel strong when she’s scared or anxious.
  • Teach your child to imagine that he is in a nice, relaxing place, a place where he feels safe. Distractions can work wonders when trying to deal with situations that cause anxiety. Children can also learn to manage their anxiety by calming their breathing and reducing the tension in their muscles. These techniques are easily available on the internet (see the websites below).
  • Children may begin to feel anxious and anxious in the event of the conflict between their parents. Difficult conversations between parents should take place when children are not present.
  • Help your child to have a good physical health and regular routines. Make sure he has a balanced diet, good sleep habits, and good physical condition through exercise. Allow time for your child’s recreation and relaxation.

Where should I get help if I think my child’s fears and anxiety are worrying?

Despite your best efforts to help your child cope with his fears and anxiety, there may be times when your child’s thoughts and emotions upset him to such an extent that you cannot cope alone.

You should also consider:

  • Talk to your child’s teacher and other adults (coaches, instructors) who interact with your child. There may be a problem you are not aware of.
  • Find books and websites that could help everyone, including you, your child, and other family members to better understand what they are experiencing.
  • Contact your family doctor or pediatrician. The time for a health check may have come and it may be a good time to talk about what might be causing these symptoms in your child. Your doctor will help you decide if your child needs to see someone, such as a child psychologist, to help them overcome their fears and anxiety


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