Anxiety Disorders in Children

— by Katy M. Clark

My daughter was nine years old when she had her first panic attack. She was trembling, out of breath, and her heart pounded. These symptoms persisted for almost ten minutes and nothing I said or did could help her calm down. Because her symptoms occurred before her performance in a class play, though, I dismissed it as stage fright.

When she suffered the same symptoms a short time later, this time before a party at her school, I realized something was wrong. Especially when she told me what triggered her intense physical symptoms — she could not stop worrying that something bad would happen to me as I drove to her school.

Having some anxiety is a normal part of life for most kids. After all, what child doesn’t feel anxious before taking a test? Or making a presentation in front of the class? And what about trying out for the team?

Some children, though, feel worry or fear constantly. According to the Mayo Clinic, anxiety disorders involve “intense, excessive and persistent worry and fear about everyday situations.” Further, such feelings of anxiety and panic “interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time.”

The CDC reports that 9.4% of children aged 3-17 were diagnosed with anxiety in 2016-2019. That’s 5.8 million kids. And since the COVID-19 pandemic, the number of kids with an anxiety disorder will undoubtedly increase.

After visiting the pediatrician, my daughter was diagnosed with Generalized Anxiety Disorder. Now she sees a therapist and takes medication to treat her anxiety. Through her experience, I have learned so much about anxiety disorders in children. I’m sharing what I’ve learned below in hopes of helping other parents and caregivers.

Types of Anxiety Disorders in Children

There are several types of anxiety disorders, related to what the worries or fears are about, or how children handle them. According to WebMD, the most common anxiety disorders in kids include the following:

• Generalized Anxiety Disorder (GAD) is constant worrying about a lot of different things out of proportion to the actual circumstance.

• Panic disorders are characterized by sudden, intense fear that leaves a child feeling physically overwhelmed and out of control, even when there is no danger.

• Separation anxiety is the fear that something bad will happen to a parent or loved one when the child is separated from them. Some separation anxiety is a normal developmental phase for babies and toddlers, but not necessarily for older children.

• Social anxiety is extreme anxiety and fear of being embarrassed in social situations, like talking with classmates or answering a question in class. It is more than simple shyness.

Symptoms

According to the CDC and WebMD, the most typical symptoms of anxiety disorders in children include:

• Showing anxiety or expressing worry or fear on most days, for weeks a time

• Trouble sleeping which may manifest in your child seeming sleepy or tired during the day

• Difficulty concentrating or thinking about a problem over and over again

• Unusually irritable and angry

• Headaches

• Stomachaches

• Avoiding school or friends because worries are overwhelming

• Trouble calming down after leaving a parent or loved one, or extreme homesickness

How to Help

The CDC recommends talking to your healthcare provider as a first step. This is what we did in my daughter’s case when we visited her pediatrician. A primary care doctor or mental health specialist can evaluate your child and ensure that your child’s symptoms are caused by anxiety and not another condition, such as trauma.

Cognitive behavioral therapy (CBT) and medication are the most accepted treatments to help children overcome an anxiety disorder according to the Anxiety Disorders Association of America.

CBT teaches your child skills and tools to help them feel less anxious and fearful. Through CBT, for instance, my daughter learned to utilize tools like a “worry box.” She’d write down her worry on a piece of paper, then stuff the paper in a box. It was a tangible way to release her fear.

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What Do Your Teens Want?

Parents of teens often acknowledge they’re navigating uncharted territory and are open to advice from those who’ve gone before. Teens are going through tremendous emotional, physical, and social changes while their parents may also be facing a series of firsts: aging, end of reproductive cycles, and mid-life crisis issues. The transitions faced by both teens and their parents can make for some challenging times at home.

Teens need room to grow and change. While they’ll resist “micro-managing,” they may be prone to taking risks that require intervention for their own safety. They want to stand on their own two feet and push parents further away as they turn to peers for advice. They may become resistant to family rules that used to be accepted, and they can seem sullen and uncooperative. In short, parents look at their beloved child and barely recognize the sweet little person they were just a short while ago.

On the other hand, teens are vibrant and have energy to burn. They can be very idealistic and full of plans to make the world a better place. They become passionate about causes and are very loyal to friends. They are in the process of developing the person they’ll eventually become as an adult and may explore many creative outlets in that effort.

Teen-age years are dynamic times filled with joys and struggles. Parents have the responsibility to nurture them through these times. So… what do teens really want?

To Belong

Although friends, teachers, and mentors will play a large role in your teen’s life, your family will always be their primary place of belonging. Home is where they’re nurtured and loved and where they return after venturing out in the world. Home should always be a welcoming place.

Building and maintaining a positive bond with teens is the goal. And though discipline will need to be part of family life, as much as possible make encouragement, positive words, and camaraderie be the norm. Spend time together. Family meals, game nights, and weekend outings may not come as often as they did before teen years, but they should still happen. Including teen friends in family events makes it more fun for all.

Teens need to know that they always have a place of belonging in the family.

To Be Heard

Teens are either holed up in their bedroom or away with friends. So when are parents supposed to listen to them? It’s a challenge, for sure. But teens have strong feelings about the issues of the day and they have a need to share their thoughts. Some parents plan times when the family focuses on a topic of the day to process together. Such events give room for all family members to voice their thoughts.

Teens are trying out new ideas as they encounter them. They may take a stance in opposition to the ways you’ve taught them at home as an exercise in exploration. Parents who listen rather than correct or become angry will model a healthy way to encounter opposing views.

Teens also need a safe place to ask questions troubling them or talk about behaviors amongst their friends that concern them. Today’s world requires that teens make important decisions about alcohol, drugs, and sexual behaviors at an early age. These topics may be hard to discuss openly, but your teens need support as they face them.

Teens need to know their family will listen.

To Be Safe

Parents of teens need to be aware of the world their teens are living in daily. Where do they go and what are they doing? Who do they spend their time with and are they in safe spaces? Parents need to be willing to step in and “rescue” their kids if they find themselves in an unsafe situation. A code word decided upon by the entire family is one way to stay safe. A text of that one word means, “Come get me.”

Teen years require clear boundaries set by you, their parents. Reasonable expectations mean your teen can comply and there may be room for flexibility when they behave responsibly. Consequences should be both fair and immediate. Rules are meant to keep your child safe and discipline is about teaching appropriate ways of living.

Keeping lines of communication open is a challenge in teen years, but can go a long way in keeping your teen safe. Engaging in casual talks about how life is going in general can open up deeper levels of communication when important topics need to be addressed.

Teens want to feel safe.

To Be Loved Unconditionally

While teens need privacy and want to be with their friends more than at home, they still need to feel loved by family members. Anything parents can do to demonstrate that unconditional love is a plus. Some teens welcome hugs while others prefer a less “fluffy” pat on the back or high five.

Although much of parenting is reminding kids to do their chores or homework, strive to make your interactions positive every time you can. We adults like to hear positive words and affirmations, and so do teens.

It’s important to show appreciation for your teen’s efforts and not only for their accomplishments. Trying a new sport or joining the drama club may not produce stellar performances, but will be character-building. Look for ways to praise genuine effort.

When a teen makes a mistake or breaks rules, there is opportunity to show real love. Consequences meted out fairly, coupled with assurances of love and support, can turn a bad situation into a learning opportunity.

Say the words. Tell your teen you love them often.

Teens need to know they’re loved.

Jan Pierce, M.Ed. is a retired teacher and author. She writes about a wide variety of topics related to parenting, grandparenting, and education.

Prescription medication may also help. Parents should work closely with a health care provider to manage the use of medication and monitor your child’s response.

As well, WebMD advocates that parents should let their children know they are available to listen whenever their children are ready to talk. Many kids with anxiety believe their parents won’t understand and thus try to hide their fears. That’s why being ready to listen is so important.

My daughter also joined an anxiety disorder support group at her school, allowing her to connect with peers who understand what she’s going through. As well, I have found support in talking to other parents of children with anxiety disorders. So many have been supportive and understanding, making me feel less alone.

Anxiety is a treatable, manageable condition. As parents, we can help kids with anxiety disorders receive the tools, support and love they need to live their healthiest lives possible.

Katy M. Clark is a writer and mom of two who celebrates her imperfections on her blog Experienced Bad Mom. She’s an award-winning writer whose work has appeared on Scary Mommy, Today’s Parent, and Your Teen for Parents. Her articles have appeared in Pregnancy, Atlanta Parent, and many more publications.

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