“My son can’t seem to stop worrying,“ an Austin mother lamented recently. “He worries about things even when there’s no reason.” Excessive worrying that lasts for at least six months can be a symptom of anxiety. Fifteen to 20 percent of children and adolescents have this common mental health condition. Many children who have anxiety also have other concerns, such as depression or attention deficit hyperactivity disorder (ADHD). Fewer than one out of three people who have anxiety disorders are getting treatment, according to the Anxiety and Depression Association of America (ADAA). Many children aren’t getting the help they need because parents don’t know what to look for.
Symptoms of Anxiety
It’s normal to worry or be nervous about certain situations — the first day at a new school, a math test, a piano recital or a big game. Feeling a little anxious can motivate your child to prepare and do her best. The problem is the degree of anxiety. If the anxiety is intense, lasts for a long time or gets in the way of normal activities, she needs help.
Some symptoms of general anxiety are listed in the sidebar. Physical symptoms can occur as well. The child may complain of a headache, stomach ache or muscle aches. She may feel tired for no reason. Some children have trouble swallowing, feel out of breath or feel light-headed. Other symptoms are sweating, nausea and trembling.
Types of Anxiety
Anxiety disorder is an umbrella term that includes several mental health conditions, such as general anxiety disorder, panic attacks, separation anxiety and specific phobias. Others not discussed here are social anxiety, obsessive-compulsive disorder and post-traumatic stress disorder. Symptoms for each disorder are different.
General Anxiety Disorder. Sometimes people who have general anxiety are described as “worry warts.” They worry excessively, often without cause. They dwell on negative thoughts. They can be very emotional, bursting into tears at the slightest provocation. Children with general anxiety can be irritable and have tantrums.
Panic Attacks. These are brief episodes of terror. The child may have a pounding heart and feel dizzy or faint. Some people describe a sense of choking, being smothered or that “the world is closing in.” Some people have a panic attack only once. People who have panic attacks more often can begin to avoid certain situations. In severe cases, panic attacks restrict normal life, such as going to the store or driving a car.
Separation Anxiety. This is a fear of leaving the safety of parents or home. Parents may have a hard time getting their child to go to daycare or school. The child may be “clingy” or afraid to stay in a room by herself. She may have nightmares and be afraid of the dark.
Phobias. A phobia is an unreasonable fear of something. Specific phobias usually start in childhood (on average at age 7). One mother reports that her son refused to enter any outdoor bathroom because he had seen a spider once in a park bathroom.
What to Do
Educate yourself. The more you understand about anxiety disorders, the better prepared you will be to help your child. See anxietybc.com for information, resources and tools you can use right away.
Talk with your child. It’s important to talk about what your child is feeling and thinking. Give her your full attention. Don’t discount or ignore her symptoms. Develop a My Anxiety Plan (MAP) at anxietybc.com.
Take your child to the doctor. Some symptoms of anxiety also can be symptoms of other illnesses. For example, feeling tired can be a symptom of anemia. If the cause of your child’s distress is an anxiety disorder, ask the doctor for a referral to a mental health provider who specializes in anxiety in children.
Develop a treatment plan. Work with your child’s providers. If he’s having trouble at school, involve his teacher or guidance counselor. Anxiety disorders can be treated successfully with medicine and cognitive-behavioral therapy (CBT). CBT is “talk therapy” and has been shown to be very effective.
Seek out strategies. Learn about other approved strategies for anxiety, such as meditations designed specifically for children. The Ohio Chapter of the American Academy of Pediatrics has a handout “Helping Your Child Cope with Anxiety.” It includes simple strategies for routines and social support, plus tools and a book list. Find it at tinyurl.com/y9u5tlpx.
By Brenda Schoolfiend, a freelance medical writer who splits her time between Austin and Seattle.