by Jan Estrellado, M.A.
No one wants to think about children struggling with anxiety. However, anxiety disorders are the most common psychiatric disorder in teens and tend to start around the age of 6 (Merikangas et al., 2010).
What does anxiety look like in children and adolescents? Does it differ from adults? To find out these answers, one can look to the research and to mental health clinicians with experience in these areas.
How Common is Anxiety in Kids?
Anxiety disorders are the most common psychiatric disorder of 13 to 18 year olds (40.2%; Merikangas et al., 2010). Of the teens with anxiety disorders, 8.3% are severely impaired by their anxiety disorder. However, 80% of kids with an anxiety disorder do not receive treatment. Interestingly, kids tend to develop anxiety disorders at the age of 6 (versus age 11 for ADHD and age 13 for mood disorders, like depression).
Why might it be that the most common psychiatric disorder in young people goes largely untreated? One reason may be that parents, caregivers, and teachers may not know some common signs of anxiety in kids.
What Does Anxiety Look Like in Kids?
All kids feel anxious at one time or another, as stress is a normal part of life. In addition, many kids with shy personalities may tend to feel more nervous in general than their peers. So how does a parent know when their child’s anxiety becomes a problem?
When stress starts to get in the way of life’s activities, like withdrawing from friends, avoiding school, having trouble sleeping, experiencing difficulty being away from parents, or lashing out at loved ones, then unmanaged stress can damage the child or teen’s physical and mental health. Kids who suffer from anxiety tend to see their fears as catastrophic (Miller, 2012), which can be puzzling and confusing to some parents. Children may get extremely upset when parents or caregivers prepare to leave and may cling very tightly to their parents.
Anxiety in children may look different than in adults because kids may lack skills to express their fears and stressors. They may experience symptoms that take place in the body, also known as somatic symptoms. In young children with anxiety disorders, the most common somatic symptoms are restlessness (74%), stomachaches (70%), blushing (51%), palpitations (48%), muscle tension (45%), sweating (45%), and trembling/shaking (43%) (Ginsburg, Riddle, & Davies, 2006). Children who experience these somatic symptoms are more likely to have severe anxiety and higher levels of impairment.
What can parents and caregivers do?
Parents often know if their child is facing high levels of anxiety because they observe the child to be more anxious than his or her peers (Miller, 2012). In addition, the child’s anxiety gets in the way of everyday functioning, such as school, sleepovers, and swim class. Parents, teachers, and significant caregivers play important roles in a child’s ability to manage anxiety successfully.
Parents whose children present with these symptoms may feel their child is being manipulative or lying in order to get out of school or other activities. Learning more about your child’s fears, what management strategies you can teach your child, and how you can be supportive are successful keys to helping kids overcome their anxiety. CSAM’s own child/teen specialist, Dr. Starr MacKinnon shares that it’s important for parents to take care of themselves: “The best advice I have for parents is to remain calm and focus on self-care. The truth is, your children will predominantly learn from the model you provide them and are less impacted by your words. Children and adolescents are sponges and they will often grow up and engage in the same self-talk, behaviors, and coping that you do. So the more that you can take care of yourself and be the person you want your children to be, the better it will be for all of you.”
There are additional strategies parents and caregivers can use when helping kids cope with anxiety (Miller, 2012):
- Explain to the child that his or her feelings of worry or dread are caused by a condition called anxiety.
- Help the child notice the connection between anxiety and shallow, rapid breathing. Teach the child how to breathe slowly and into the belly.
- Encourage the child to replace anxious “red light” thoughts (“that dog will bite me”) with more helpful and realistic “green light” thoughts (“most dogs don’t bite kids”).”
Another way that Miller encourages parents to support children is through gradual learning and patience. If a child has intense fears about making a speech in front of his or her class, consider having the child read it in front of one parent first, then the family, followed by a few close friends, and so on, until the child feels confident enough to speak in front of a larger group.
If a child’s anxiety symptoms persist despite their caregivers’ best efforts, seeking professional help is recommended. Mental health professionals who specialize in anxiety treatment with kids can help train the children to develop coping strategies to manage anxiety, but can also coach caregivers to reinforce these strategies while the child is in school and at home.
Help is Here!
Parents and caregivers are the most important factor influencing whether kids develop effective coping skills to manage anxiety. The Center for Stress and Anxiety Management is here to help. Starr MacKinnon, PhD, is a licensed psychologist with a specialty interest in working with children and teens with anxiety disorders. Dr. MacKinnon shared what she enjoys about working with kids and teens: “I love working with children and teens because often they are more flexible and open to self-exploration and growth…I love helping kids and adolescents to gain insight into who they want to become so that the barriers to living that life can be addressed."
Click here to speak with Dr. MacKinnon or another professional at the Center for Stress and Anxiety Management.
Ginsburg, G. S., Riddle, M. A., & Davies, M. (2006). Somatic Symptoms in Children and Adolescents With Anxiety Disorders. Journal Of The American Academy Of Child & Adolescent Psychiatry, 45(10), 1179-1187. doi:10.1097/01.chi.0000231974.43966.6e
Merikangas, K. R., He, J., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., & ... Swendsen, J. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A). Journal Of The American Academy Of Child & Adolescent Psychiatry, 49(10), 980-989. doi:10.1016/j.jaac.2010.05.017
Miller, L. (2012). Early screening for anxiety disorders in children helps prevent mental health concerns: UBC study [Press release]. Retrieved from http://news.ubc.ca/2012/04/16/early-screening-for-anxiety-disorders-in-children-helps-prevent-mental-health-concerns-ubc-study/