Some stress and anxiety are perfectly normal for a young person going through puberty. Starting school, coping with homework and lessons, making friends and dealing with changes are some of the scenarios that can make children feel worried. Usually, such feelings disappear after accomplishing something, getting accustomed to a particular environment or hearing a word of comfort from a parent figure.
On the other hand, as a parent, it can be difficult to determine whether your child is just anxious or has an anxiety disorder that requires attention from a paediatrician or a mental health expert.
What Is Anxiety?
When a child is stressed, he or she is likely to experience some level of anxiety or fear, which is normal. Anxiety is simply the body’s way of giving a warning that there is something wrong and that one needs to be careful. Although this response is expected, it may last long and be severe at times.
Anxiety comes in various forms and can be present in children and adults in their daily lives. Severely anxious children can have their activities at school, home or at playtime affected in various ways. Early identification of anxiety in children is important in ensuring that children can control their feelings and deal with stress.
Types of Anxiety Disorders in Children
There are several types of anxiety disorders in children and they include;
It is important to understand that there are different types of anxiety which manifest in young children in different ways.
1. Generalized Anxiety Disorder (GAD)
In GAD, children have excessive anxiety about a variety of things, which may include family, friends, or school and sports activities.
2. Panic Disorder
Panic disorder in children may involve the child having an irrational feeling of fear or being scared over trivial issues or even without any cause. Panic disorder is diagnosed when a child has had at least two panic attacks and spends at least a month or more worrying about having another one or losing control. This disorder is often characterized by crying, hyperventilation, and constant worrying.
3. Separation Anxiety Disorder
Whereas normal children in the age group of 18 months to three years may feel uneasy when a parent is out of their sight, children with separation anxiety disorder are older and take a longer time to get comfortable being out of their parent’s sight. This disorder, which occurs in approximately 4% of children, involves severe homesickness and distress when apart from family and friends.
4. Specific Phobias
Specific phobia is defined as the extreme and unreasonable fear of a particular object or event.
- Animals
- Storms
- Water
- Heights
- Blood
- Darkness
- Medical procedures
5. Social Anxiety Disorder
Social anxiety disorder is also known as social phobia which is a type of anxiety disorder that is related to social and performance situations. If left untreated, this disorder interferes with the academic performance of a child and their capacity to learn and interact with others.
Signs and Symptoms of Anxiety in Children
Symptoms of anxiety in children (and adults) stem from the “fight or flight” response, the body’s natural reaction to danger. This response releases chemicals that impact heart rate, breathing, muscles, and digestion. In anxiety disorders, this response is triggered even when there is no real danger.
Common symptoms of anxiety in children include:
- Difficulty concentrating
- Fears, such as fear of the dark, being away from home or interacting with peers
- Hoarding seemingly insignificant items
- Sleep problems, including waking up at night or having nightmares
- Struggling with or refusing to go to school
- Bedwetting
- Behavioural changes, such as moodiness, aggression, temper tantrums, clinginess, or frequent crying spells
- Complaints of stomachaches or headaches
- Constantly worrying or having negative thoughts
- Changes in appetite (either decreased or increased)
- Withdrawing from family or friends
To distinguish between an anxiety disorder and a medical issue, observe when your child displays certain behaviours or physical symptoms. Pay attention to whether these symptoms occur before or after specific events. For example, if your child cries or complains of a stomachache before school, anxiety might be the underlying cause.
Teach Them Coping Mechanisms
For everyday, lower-level anxiety, parents and caregivers have many options to help children recognize and manage their anxiety.
- Set the Stage: Children often mirror their parents’ feelings. You can reduce their anxiety by showing positive support, such as encouraging them before a math exam or acknowledging that while getting a shot isn’t fun, it helps prevent illness.
- Create Opportunities for Communication: Regular, special time with parents is particularly beneficial for tweens and teens. Establish a monthly or weekly “date” to engage in a mutually enjoyable activity. Avoid bringing up anxiety-provoking topics during this time, focusing instead on providing supportive, nonjudgmental companionship.
- Rehearse and Role-Play: If your child is anxious about a specific situation, help them visualize what to expect and how to respond. For example, if they are going to overnight camp for the first time, look at pictures of the site, make a packing list, and rehearse routines like bedtime.
- Share Self-Calming Techniques: Teach deep breathing techniques such as belly breathing, which can be practised anywhere to help kids calm themselves and gain confidence. Grounding techniques, especially useful for panic-prone children, involve focusing on sensory experiences. One method is to name five things they can see, four things they can touch, three things they hear, two things they can smell, and one thing they can taste. This helps centre children and reduce immediate anxiety.
When to Worry About Their Worries
Anxiety is a normal reaction to certain situations, and occasional acute anxiety is not usually a cause for concern. Children might not show anxious symptoms even during chronically stressful times. However, when anxiety starts to impair their functioning, it becomes more concerning. Signs of impairment include:
- Frequently missing school
- Failing grades
- Avoiding social activities
- Reluctance to leave the house
While taking a “mental health day” from school occasionally is normal, missing two weeks without a medical reason is not. If you observe such behaviour in your child for a few weeks, it might be time to consult a mental health professional. You can start with free child anxiety courses online if you’re hesitant to see a professional. A good initial step is to visit your child’s primary care paediatrician to rule out any medical issues and, if needed, get a recommendation for a therapist.