Anxiety disorders cause extreme fear and worry, and changes in a child's behavior,
sleep, eating, or mood.
What Are the Kinds of Anxiety Disorders?
Different anxiety disorders can affect kids and teens. They include:
Generalized anxiety disorder (GAD). GAD causes kids to worry almost
every day — and over lots of things. Kids with GAD worry over things that most
kids worry about, like homework, tests, or making mistakes.
But with GAD, kids worry more, and more often, about these things. Kids with GAD
also worry over things parents might not expect would cause worry. For example, they
might worry about recess, lunchtime, birthday parties, playtime with friends, or riding
the school bus. Kids with GAD may also worry about war, weather, or the future. Or
about loved ones, safety, illness, or getting hurt.
Having GAD can make it hard for kids to focus in school. Because with GAD, there
is almost always a worry on a kid's mind. GAD makes it hard for kids to relax and
have fun, eat well, or fall asleep at night. They may miss many days of school because
worry makes them feel sick, afraid, or tired.
Some kids with GAD keep worries to themselves. Others talk about their worries
with a parent or teacher. They might ask over and over whether something they worry
about will happen. But it's hard for them to feel OK, no matter what a parent says.
Separation anxiety disorder (SAD). It's normal for babies and
very young kids to feel anxious the first times they are apart from their parent.
But soon they get used to being with a grandparent, babysitter, or teacher. And they
start to feel at home at daycare or school.
But when kids don't outgrow the fear of being apart from a parent, it's called
separation anxiety disorder.
Even as they get older, kids with SAD feel very anxious about being away from their
parent or away from home. They may miss many days of school. They may say they feel
too sick or upset to go. They may cling to a parent, cry, or refuse to go to school,
sleepovers, playdates, or other activities without their parent. At home, they may
have trouble falling asleep or sleeping alone. They may avoid being in a room at home
if their parent isn't close by.
Social phobia (social anxiety disorder). With social
phobia, kids to feel too afraid of what others will think or say. They are always
afraid they might do or say something embarrassing. They worry they might sound or
look weird. They don't like to be the center of attention. They don't want others
to notice them, so they might avoid raising their hand in class. If they get called
on in class, they may freeze or panic and can't answer. With social phobia, a class
presentation or a group activity with classmates can cause extreme fear.
Social phobia can cause kids and teens to avoid school or friends. They may feel
sick or tired before or during school. They may complain of other body sensations
that go with anxiety too. For example, they may feel their heart racing or feel short
of breath. They may feel jumpy and feel they can't sit still. They may feel their
face get hot or blush. They may feel shaky or lightheaded.
Selective mutism (SM). This extreme form of social phobia causes
kids to be so afraid they don't talk. Kids and teens with SM can talk. And
they do talk at home or with their closest people. But they refuse to talk at all
at school, with friends, or in other places where they have this fear.
Specific phobia. It's normal for young kids to feel scared of
the dark, monsters, big animals, or loud noises like thunder or fireworks. Most of
the time, when kids feel afraid, adults can help them feel safe and calm again. But
a phobia is a more intense, more
extreme, and longer lasting fear of a specific thing. With a phobia, a child dreads
the thing they fear and tries to avoid it. If they are near what they fear, they feel
terrified and are hard to comfort.
With a specific phobia, kids may have an extreme fear of things like animals, spiders,
needles or shots, blood, throwing up, thunderstorms, people in costumes, or the dark.
A phobia causes kids to avoid going places where they think they might see the thing
they fear. For example, a kid with a phobia of dogs may not go to a friend's house,
to a park, or to a party because dogs might be there.
What Are the Signs & Symptoms of Anxiety?
A parent or teacher may see signs that a child or teen is anxious. For example,
a kid might cling, miss school, or cry. They might act scared or upset, or refuse
to talk or do things. Kids and teens with anxiety also feel symptoms that others can't
see. It can make them feel afraid, worried, or nervous.
It can affect their body too. They might feel shaky, jittery, or short of breath.
They may feel "butterflies" in their stomach, a hot face, clammy hands, dry mouth,
or a racing heart.
These symptoms of anxiety are the result of the "fight or flight" response. This
is the body's normal response to danger. It triggers the release of natural chemicals
in the body. These chemicals prepare us to deal with a real danger. They affect heart
rate, breathing, muscles, nerves, and digestion. This response is meant to protect
us from danger. But with anxiety disorders, the "fight or flight" response is overactive.
It happens even when there is no real danger.
What Causes Anxiety Disorders?
Several things play a role in causing the overactive "fight or flight" that happens
with anxiety disorders. They include:
Genetics. A child who has a family member with an anxiety disorder
is more likely to have one too. Kids may inherit genes
that make them prone to anxiety.
Brain chemistry. Genes help direct the way brain
chemicals (called neurotransmitters) work. If specific brain chemicals are in short
supply, or not working well, it can cause anxiety.
Life situations. Things that happen in a child's life can be stressful
and difficult to cope with. Loss, serious illness, death
of a loved one, violence, or abuse
can lead some kids to become anxious.
Learned behaviors. Growing up in a family where others are
fearful or anxious also can "teach" a child to be afraid too.
How Are Anxiety Disorders Diagnosed?
Anxiety disorders can be diagnosed by a trained therapist. They talk with you and
your child, ask questions, and listen carefully. They'll ask how and when the child's
anxiety and fears happen most. That helps them diagnose the specific anxiety disorder
the child has.
A child or teen with symptoms of anxiety should also have a regular health checkup.
This helps make sure no other health problem is causing the symptoms.
How Are Anxiety Disorders Treated?
Most often, anxiety disorders are treated with cognitive behavioral therapy
(CBT). This is a type of talk therapy that helps families, kids, and teens
learn to manage worry, fear, and anxiety.
CBT teaches kids that what they think and do affects how they feel. In CBT, kids
learn that when they avoid what they fear, the fear stays strong. They learn that
when they face a fear, the fear gets weak and goes away.
Parents learn how to best respond when a child is anxious. They learn how to help
kids face fears.
Kids learn coping skills so they can face fear and worry less.
The therapist helps kids practice, and gives support and praise as they try. Over
time, kids learn to face fears and feel better. They learn to get used to situations
they're afraid of. They feel proud of what they've learned. And without so many worries,
they can focus on other things — like school, activities, and fun. Sometimes,
medicines are also used to help treat anxiety.
How Can I Help My Child?
If your child has an anxiety disorder, here are some ways you can help:
Find a trained therapist
and take your child to all the therapy appointments.
Talk often with the therapist, and ask how you can best help your child.
Help your child face fears. Ask the therapist how you can help your child practice
at home. Praise your child for efforts to cope with fears and worry.
Help kids talk about feelings. Listen, and let them know you understand, love,
and accept them. A caring relationship with you helps your child build inner strengths.
Encourage your child to take small steps forward. Don't let your child give up
or avoid what they're afraid of. Help them take small positive steps forward.
Be patient. It takes a while for therapy to work and for kids to feel better.