Childhood Anxiety what does anxiety look like in children?

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Childhood Anxiety

Depending upon the developmental age of a child, some anxiety in children is normal. Children with anxiety disorders experience intense worry, fear, or uneasiness that can last for long periods of time and significantly impact their lives.


  • Obsessive Compulsive Disorder

  • Separation Anxiety Disorder

  • Generalized Anxiety Disorder

  • Social Phobia or Specific Phobia

  • Panic Disorder


  • In children and adolescents, anxiety symptoms may include irritability, somatic complaints (i.e., headaches, stomach aches) and school avoidance.

  • Children with anxiety often have sleep difficulties (usually falling asleep).

  • Children with anxiety may also appear inattentive, as they are focusing on their worries.

  • Depression and anxiety often coexist in adolescents with emotional distress.

  • Childhood anxiety may be expressed through your children’s behaviors, such as aggression, tantrums, or defiance.


Research remains uncertain regarding the specific causes of anxiety disorders. However, if parents experience anxiety, children are at a higher risk for developing an anxiety disorder. While the exact cause of anxiety disorders is unknown, it is becoming clear that many of these disorders are caused by a combination of factors, including chemical reactions and changes in the brain and environmental stress.

Studies have also shown:

  • Severe or long-lasting stress can change the balance of chemicals in the brain that control mood.

  • People with certain anxiety disorders have changes in certain brain structures that control memory or mood.

  • Anxiety disorders can be inherited from one or both parents.

  • Certain environmental factors, such as a trauma or significant event, may trigger an anxiety disorder in children who have an inherited susceptibility to developing the disorder.


With anxiety disorders limiting the lives of at least one in ten children, there has been much progress made in the treatment of children with these disorders. Although the exact treatment approach depends on the type of disorder, it has been found that at least half of the children affected aren’t helped with psychotherapy or medication alone. A combination of medication and therapy are commonly used for most anxiety disorders.


Because it is believed that many of the anxiety disorders have links to chemical imbalances and reactions, anti-anxiety medication works to help bring equilibrium.

  • Some medications in the treatment of anxiety work by decreasing abnormal electrical activity in the brain and depressing the central nervous system, which is often overactive in children with anxiety disorders.

  • Other anti-anxiety drugs work on the neurotransmitter serotonin. Some of these drugs increase serotonin’s effect on the central nervous system which decreases anxiety, while others work on increasing the levels of serotonin in the brain.

  • It is important to note that medications aren't meant to change specific behaviors, but to help rebalance the chemicals in the brain to give a child more flexibility in thinking about situations. Medications that are working well will give a child more time to consider their best option.


Psychotherapy addresses the emotional response to anxiety by helping children talk through strategies for understanding and dealing with anxiety. Cognitive behavioral therapy (CBT) is the most effective therapeutic approach for children with anxiety. CBT helps the child recognize and change thought patterns and behaviors that lead to anxious feelings. Strategies include learning relaxation strategies, gradual exposure to feared situations, challenging negative self-statements, learning to modify the ways they think and behave, and family anxiety management training.


  • Reduce outside stressors, whenever possible.

  • Acknowledge specific fear and provide support in learning to manage that fear.

  • Provide a safe place when feeling overwhelmed in school.

  • For test anxiety, the child may require a quiet room free of distractions, modified test-taking options (i.e., multiple-choice vs. essay), and/or the opportunity to correct their mistakes.


  • Acknowledge your child’s fears and provide them with practical information to counteract their irrational fears and worries.

  • Remind them to use their relaxation and cognitive-behavioral strategies.

  • Do not punish for worrying. Instead, provide options and a plan.

  • Prepare your child for changes, transitions, or times that make your child feel more anxious.

  • Model positive coping strategies.

  • Encourage gradual exposure to fears.

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