Understanding and supporting children with anxiety

According to the Centers for Disease Control and Prevention (CDC), 7% of children have diagnosed anxiety. Additionally, the National Institute of Mental Health estimates that nearly 1 in 3 of adolescents aged 13-18 have an anxiety disorder. When left untreated, anxiety disorders can lead to poor school performance or socialization, loss of sleep and even eventual substance abuse.

"Anxiety is excessive, unmanageable worry that makes it difficult to concentrate on necessary tasks or fun activities," explains Roshini Kumar, LPC, clinical therapist at Children's Health℠. "Anxiety can affect both our brains and our bodies and make us feel helpless and sad if not corrected."

Types of anxiety disorders in children

While anxiety is a normal emotional response to stress, anxiety disorders are mental disorders characterized by persistent, overwhelming worry or fear. Anxiety types and their symptoms can include:

• Generalized anxiety disorder – This disorder involves excessive, uncontrollable worry, and can include difficulties with concentration, sleep, energy, muscle tension, irritability and restlessness.
• Specific phobia – This is an intense fear of a specific situation or object that may lead to avoidance of important or necessary activities.
• Social anxiety disorder – This disorder describes persistent, overwhelming anxiety about being judged or rejected in social situations. Children can express this fear by crying, having tantrums or refusal to speak, among other behaviors.
• Separation anxiety disorder – This disorder occurs when children experience excessive anxiety when separating from loved ones. It often includes refusal to leave home, nightmares and uncontrollable worry about harm to a loved one, among other symptoms.
• Panic disorder – In this disorder, feelings of intense fear strike suddenly and regularly, without warning. Physical symptoms like irregular heartbeats, muscle tightness, shortness of breath and sweating, among other symptoms, often occur.
• Selective mutism – In selective mutism, children consistently do not speak in settings where it's necessary to do so. Because of this, schoolwork or necessary activities are negatively impacted.

Best ways to help a child with anxiety

To help your child with anxiety, it's important to know the symptoms of anxiety. To support your child:

• Choose a specific time of day to check in about mood. This can be around the breakfast or dinner table, or on the way home from school. This provides a space for children to be prepared to express their feelings.
• Notice measurable changes in behavior that could indicate anxiety. For example, if grades start slipping, your child could have difficulty concentrating.
• Model healthy behavior by practicing coping skills with your child. Take deep breaths together, take a long walk, color or paint while listening to relaxing music.
• Practice positive thinking. Try changing a negative thought to reflect truth and positivity.
• Acknowledge and praise your child's successes. Create a list of accomplishments to display on the fridge and add to this list frequently.
• Notice when symptoms become unmanageable and ask for help from your pediatrician or a licensed mental health professional.

Hear more about ways to recognize anxiety and help your child cope.

How to treat anxiety in children

Therapy for kids with anxiety

Your child's doctor or therapist may recommend a form of talk therapy called cognitive behavioral therapy (CBT) to help your child figure out ways to think and act in situations that normally cause anxiety. CBT focuses on identifying negative thought patterns and changing these thoughts to reflect positivity. Your child's doctor may also recommend individual psychotherapy, parent guidance sessions, group psychotherapy (with other children) or school-based counseling, depending on your child's needs.

Activities for children with anxiety

The doctor or therapist may recommend physical activities and mental strategies to ease anxiety. Physical activities that can help calm anxiety in children include:

• Taking deep breaths
• Using grounding techniques like noticing something you can see, hear, smell, touch and taste
• Going to a safe space in your home to engage in a relaxing activity, like reading or drawing
• Engaging in a distracting activity, like "I Spy" or a board game

Mental strategies to help children with anxiety include:

• Recognizing early physical warning signs of anxiety, like muscle tension or restlessness
• Identifying the thought that pops up when physical warning signs occur Many times, this thought starts with 'what-if', and focuses on the worst-case scenario
• Help your child reframe the thought to reflect truth and positivity
• Practice ways to catch negative thoughts and reframe them throughout the day

Medication for anxiety in children

If your child's anxiety is severe and does not respond to behavioral therapy, the doctor may recommend a type of antidepressant – known as a selective serotonin reuptake inhibitor (SSRI) – to reduce symptoms.

Learn more about treating anxiety in children

Children's Health can help children and teens manage feelings of loneliness, depression and anxiety. Learn more about programs we offer to support mental, emotional and behavioral health.

You can also access emotional care and support from the comfort of your home with Virtual Visit Behavioral Health. With a behavioral health care appointment, you can speak to a board-certified psychiatrist or licensed therapist using video technology. Learn more about Virtual Visit Behavioral Health.

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