How to spot anxiety in children

How to spot anxiety in children
Anxiety disorders are a type of mental health condition that cause extreme fear or worry and lead to changes in a child’s mood, behavior, eating, sleep, and other daily functions. (Photo: Freepik)
It is not unusual for children to feel anxious or worried from time to time, especially if they are starting school or kindergarten or going through different stages of development. اضافة اعلان

Feelings of distress and worry stem from new fears that match that developmental stage. For example, toddlers fear being away from their parents, or middle schoolers worry about an upcoming exam.

However, some children experience anxiety persistently or extremely to the point where it affects their thoughts and feelings and interferes with everyday functioning. When that is the case, it could be possible for the child to have an anxiety disorder.

Anxiety disorders are a type of treatable mental health condition that cause extreme fear or worry and lead to changes and disruption in a child’s mood, behavior, eating and sleeping pattern, and other daily functions.

Since anxiety disorder symptoms primarily involve thoughts and feelings, they are commonly referred to as internalizing disorders. It is common for anxiety to go unnoticed for a long time.

The lack of detection could be due to one of two main reasons: the anxious child is seen as quiet and well-behaved, therefore labeled as a “good kid” who is doing just fine on their own; or the anxious child is disruptive and acts out, leading those around them to label them as a “bad kid” with a behavioral problem that requires stricter discipline.

Prevalence of childhood anxiety

According to the US Centers for Disease Control and Prevention, 9.4 percent of children aged 3–17 years were diagnosed with anxiety in 2019.

However, a report published by the World Health Organization claims that the prevalence of anxiety increased by 25 percent due to COVID-19.

A 2018 study published in the Perspectives in Psychiatric Care Journal that looked at anxiety and depression among school students in Jordan found that 73.8 percent of students were experiencing anxiety, with Internet addiction and school classes being the two main risk factors.

Another Jordanian study published in the Youth & Society Journal in 2021 revealed that 78.2 percent of Jordanian adolescents experienced severe anxiety symptoms.

Statistically shown high prevalence of anxiety among Jordanian children and adolescents emphasizes the need for increased awareness and investment into mental health programs and developing counselor centers to address this global concern.


Several factors play a role in triggering a child’s fight or flight response which is prevalent with anxiety disorders, the first being genetics. A child with a family history of anxiety disorders is likely to inherit that gene and become more prone to developing an anxiety disorder.
A 2018 study published in the Perspectives in Psychiatric Care Journal that looked at anxiety and depression among school students in Jordan found that 73.8 percent of students were experiencing anxiety, with Internet addiction and school classes being the two main risk factors.
Another factor is brain chemistry, where a child with poor functioning or a short supply of specific brain chemicals (neurotransmitters) might also become more likely to develop anxiety. In addition, some health conditions such as heart arrhythmia, thyroid problems, or being on certain medications or substances may aggravate anxiety symptoms in a child.

Other environmental factors may include a child going through stress in daily life or a specific situation, including dealing or coping with a difficult loss, trauma, serious illness, death of a loved one, and violence or abuse.

Finally, anxiety can also develop in a child through learned behavior. Being surrounded by family members, especially parents who are anxious or fearful, can teach a child also to be afraid.

Symptoms and diagnosis of anxiety in children

If you believe your child might have anxiety, some signs to look out for are difficulty concentrating at home or school, having nightmares, experiencing disrupted sleep, or sudden loss or gain of appetite.

Behaviorally, they might become more irritable, throw tantrums, easily cry, and become overly clingy. They will frequently complain of stomach aches, feeling generally unwell, or constantly express feeling worried or having negative thoughts.

Anxiety disorders can be diagnosed by a trained clinical therapist who will do a full mental health evaluation and talk to the parents and the child to ask about symptoms, triggers, and other questions that will help figure out which specific anxiety disorder the child has.

The child will then have to do regular health check-ups and follow the therapist’s treatment plan.

Types of anxiety disorders

Generalized anxiety disorder (GAD) is considered the most common type of anxiety disorder that can be first diagnosed in childhood. For a person to be diagnosed with GAD, they must experience anxiety symptoms almost every day for a period longer than six months, with little to provoke their anxiety.

Some of the most common symptoms of GAD in children include restlessness or feeling on edge, having an irritable mood, difficulty sleeping or focusing on anything, often feeling fatigued, and excessively worrying about things such as school performance, personal safety, or event about possible natural disasters.

A child with GAD will always imagine the worst that can happen.

When a child experiences such anxiety, it becomes difficult for them to concentrate, learn, participate, or even communicate effectively, making them feel insecure or self-conscious, constantly seeking reassurance and validation, and becoming overly concerned with meeting everyone’s expectations. 

Obsessive-compulsive disorder (OCD) is another prevalent anxiety disorder amongst children.

Children with OCD experience intrusive, repetitive, and unwanted thoughts and perform compulsions or repeated activities and rituals to relieve themselves of the anxiety that results from such thoughts.

While OCD may develop at any age, the onset age is typically between 8–12 years old.

Living with OCD causes extreme distress and embarrassment for children who have their daily functioning constantly interrupted.

Panic disorders cause children to experience unexpected, recurring panic attacks, which are intense episodes of extreme anxiety with no apparent outside trigger.

During a panic attack, a child might experience heart palpitations or increased heart rate, feeling short of breath, sweating and chills, shaking or trembling, feeling numb or dizzy, and feeling a loss of control.

If your child is experiencing a panic attack, focus on helping them take deep, slow breaths; you can even give them a paper bag to breathe into as well.

Specific phobias are another manifestation of anxiety disorder. A child with a particular phobia will experience intense fear of a specific object or situation.

What separates phobias from experiencing regular fear is that phobias do not decrease with reassurance, and the level of fear usually does not match the situation.

Like other anxiety disorders, a child with a specific phobia will do their best to avoid any situation, even regular everyday situations, that might trigger their phobia, even where it does not make sense.

Social anxiety disorder, also commonly referred to as social phobia, is when a child experiences severe anxiety and self-consciousness about mundane, everyday social situations.

However, social anxiety disorder is more than just shyness and causes extreme distress for the child who is terrified that they will embarrass themselves if they talk to classmates or teachers, answer questions, do presentations, eat in public, join conversations, or any other activity that requires social interactions.

This fear can also keep the child from participating in school or other activities due to the fear of being rejected by others around them.

Such phobia is more common in adolescents, with the average age of onset being 13. However, it can occur in children as young as four years old.

Separation anxiety disorder is another common anxiety disorder among children. To some level, almost all children have separation anxiety, especially during transitional periods in their life. However, when an older child gets unusually upset if a parent or someone close to them leaves, even for a short period of time, and starts crying or has trouble calming down when saying goodbye, they may have separation anxiety disorder.

Children with this disorder easily get homesick when being away from home for a camp, sleepover, or playdates. This affects their ability to function socially and academically and will make it more difficult for them to maintain friendships as they refuse to go to social events to avoid being away from their parent or caregiver.

Treatment of anxiety disorders

After getting an official diagnosis, a therapist will most likely begin to treat anxiety disorders with cognitive-behavioral therapy (CBT).

CBT is a type of talk therapy that helps patients learn to deal with and manage their worry, fear, and anxiety. With children, CBT teaches them that when they avoid their fear, their fear does not go away, and so they must learn to face their fear so that it grows weak and vanishes.

It also teaches them coping skills to help them face their fear and worry less. In some cases, medicine prescribed by a pediatric psychiatrist might also be used.

As for parents, the first step to do is to take your child’s anxiety seriously, as many children group up failing to receive the help they desperately need.

Studies have shown that untreated anxiety can lead to depression, substance abuse, and decreased quality of life.

Building a caring relationship with your child will help them build inner strength. Create a healthy lifestyle for them that ensures that they eat healthy, get enough sleep and exercise, and teach them mindfulness and relaxation techniques.

Help your child by encouraging them to talk about their emotions, face their fears, and make them feel loved, understood, and accepted.

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