• Danielle Ibelema, MD

How Anxiety Can Manifest in Children


Anxiety disorders are the most common mental health disorders in the United States. We often think of anxiety as a condition of adulthood, but this is not true. Children and adolescents may also have anxiety. It’s estimated about 7 % of children have a diagnosed anxiety disorder. There is likely a larger percentage of children who have an undiagnosed anxiety, and current estimates likely do not reflect the most recent upticks in mental health symptoms among all age groups.


The effects of the pandemic, and its associated uncertainty, isolation and disruption of routines, social norms have been stressful and unsettling for all. Add to that political conflict, social unrest, and the resurfacing of our painful collective history, we have the makings of trigger points for discomfort, angst and anxiety.


The level of understand of the complexity of these factors may depend on the developmental stage of the child, yet children even a young child can pick up on the stress or emotional undertone of their environment. A young child may not know what a virus is or know even about the shadows of our nation’s history or the struggles and displacement of others on the other end of the globe. Yet, children are like sponges, and often absorb the emotional tone of the environment they are in. They may be aware that mom is sad, that dad is anxious, or that the adults around them seem tense.



Signs and Symptoms of Anxiety in Children


· Excessive worrying


· Difficulty focusing on schoolwork


· Extreme fear of separation from parents


· Intense fear regarding specific objects or situations (such as dogs, snakes, crowds)


· Heightened worries about school or being away from home


· Constant worry that something bad will happen in the future


· Somatic complaints such as abdominal pain or headaches


· School avoidance




Compared to adults, children are more likely to have somatic complaints with anxiety disorders. Physical symptoms may include an inability to sleep, abdominal pain, sweating, headaches, heart palpitations, or trouble breathing.




What Can Parents Do If Their Child Has Anxiety?


Talk With Your Child

Children may not have the capacity to verbally express their anxiety. It’s helpful for parents to keep open lines of communication and to encourage routine conversations about their emotional experience. Questions such as “How are you feeling today?” “I notice you look sad today. Can we talk about it?” or “I know you saw ‘xyz’ on the news today… how did that make you feel?”. By engaging a child in this way a parent is both tuning into their child’s emotional state and they are modeling the idea that it is ok to talk about one’s internal state and to communicate about one’s mental health needs. This is invaluable for a developing child.



Talk to a Healthcare Professional

It’s important to get a child help early. Due to lack of awareness, stigma, or difficulty getting access to child psychiatrists, and other mental health professionals, there is often a delay to accessing care. According to NAMI (The National Alliance of Mental Health), the average delay between onset of mental illness symptoms and treatment is 11 years. This means that a young person may go 11 years unnecessarily suffering from an illness due to a lack of treatment.


Once a child has access to care, there are a few options for the treatment of anxiety. Medication, psychotherapy and lifestyle modifications can all help with the treatment of anxiety disorders in children.