An Introduction to Anxiety and Anxiety Disorders in Children

Anxious about your child’s anxiety? Clinical Mental Health Counselor Alexandra Schuur walks us through how anxiety may present in children, how to spot it, and steps we can take as parents to help them.

By Alexandra Schuur

Anxiety in children has long been a hot topic in the mental health world. Over the last decade, parents might have seen worrying statistics in parenting magazines, books, and online. Respectable sources across the world such as the World Health Organization (WHO),¹ UNICEF,² and the Centers for Disease and Control Prevention (CDC)³ are all in agreement: the recorded numbers of children presenting with mental health disorders are on the rise. This is especially true since the pandemic hit.⁴  As a result, many parents are feeling the pressure to take action and prevent their children from being exposed to stress-inducing triggers. 

Fortunately, a great deal of research has been done on anxiety in children in recent years, and although we have much more to learn, we know the basics. We have identified various types of anxiety, the potential causes, symptoms to look for, and when it is time to seek professional help. 

When discussing anxiety, it is important to differentiate between ‘normal’ anxiety and an anxiety disorder. Both can be induced by events or experiences, often referred to as a ‘trigger’. Some examples are major life events such as the loss of a loved one, moving to a new school, or bullying. Other anxiety triggers include experiences with violence, verbal abuse, illness, and natural disasters. As a parent, you can take action to shield your child from some of these triggers, though you will find that many of these life events are unavoidable, and experiencing them is part of growing up. 

A child can experience normal anxiety, or stress, in response to any of the aforementioned triggers. Anxiety is a natural response to a stressful situation and part of human nature. This form of anxiety is often referred to as the ‘fight or flight’ response; an internal warning signal, telling us to be alert. Experiencing normal anxiety is part of a child’s development and can even lead to positive outcomes such as increased resilience and the development of effective coping strategies. Anxiety can also increase motivation and concentration for events such as academic tests and sports competitions. In young children, normal anxiety might include temporary symptoms such as difficulty sleeping, a sudden drop in appetite, crying, clingy behavior towards a caregiver, irritability, or even physical symptoms such as a headache or stomachache. Presenting symptoms are proportionate to the trigger, last only for the duration of it, may even be beneficial in some way, and can usually be managed with basic stress-coping strategies. Fortunately, children are often quite good at developing coping strategies for normal stress, which might include exercise, play, talking to a friend, reading, drawing, or a hug from a loved one. 

Anxiety disorders in children can either be triggered by a single event, or develop over a period of time. Many of the symptoms observed in a child with an anxiety disorder can be the same as those experienced with normal anxiety. However, the way they present can be quite different. For instance, unlike the temporary symptoms experienced in ‘normal’ anxiety, anxiety symptoms in a child with an anxiety disorder can last well past the presence of the trigger. They are also often disproportionate to the trigger, can be in response to unrealistic thoughts or worries, and are typically more difficult to manage. Additional symptoms might include physical behaviors such as verbal or motor tics, rocking, and avoidance behaviors. Finally, unlike the upshots of normal anxiety, there are no benefits gained from an anxiety disorder due to the severity and frequency of the symptoms experienced. In fact, the symptoms are typically debilitating in nature and negatively impactful on several main areas of the child’s life such as school, friendships, and home. In these cases, it is advisable to seek professional help.  

With appropriate professional support, anxiety disorders in children can be diagnosed and treated. Those most commonly diagnosed in children include generalized anxiety disorder (GAD), separation anxiety disorder, specific phobias, selective mutism, social anxiety disorder, and panic disorder. The most common treatment methods for children include medication and cognitive behavioral therapy (CBT).⁵ Not all children will require medication, though if required, it is best to pair it with some form of therapy or counseling support. This means that a child’s treatment team might include a pediatric psychiatrist and a professional psychologist or clinical counselor. In addition, parental support as well as support from homeroom teachers and school counselors play a key role in the child’s progress and continued well-being. 

It is important to remember that although the reported number of children with anxiety disorders has increased over the past several years, the anxiety most children experience is ‘normal’. Being a young child during a global pandemic is not easy, and your child may very well experience several anxiety triggers during this time. For instance, your child might be anxious about the return to school when they have been learning remotely for several months. This is a perfectly normal response to a stressful situation. If, however, your child refuses to return to school altogether, for a prolonged period of time, it is advisable to seek support. Now, if you have concerns about your child’s mental health, I would advise you to talk to them about your concerns before booking an appointment with a professional. See if you can help your child to identify the emotions they are experiencing, and discuss possible coping strategies. As parents, you know your child best and will likely be able to accomplish a lot simply by listening to your child, and opening a dialogue. You can take your cue from there. 

Photos from Canva.

References

¹  WHO (2021) Adolescent mental health. who.int/news-room/fact-sheets/detail/adolescent-mental-health

² UNICEF (2021) Mental health. data.unicef.org/topic/child-health/mental-health/; unicef.org/press-releases/impact-covid-19-poor-mental-health-children-and-young-people-tip-iceberg

³CDC (2021) Data and Statistics on Children’s Mental Health. cdc.gov/childrensmentalhealth/data.html

⁴ UNICEF (2021) At least 1 in 7 children and young people has lived under stay-at-home policies for most of the last year, putting mental health and well-being at risk. unicef.org/rosa/press-releases/least-1-7-children-and-young-people-has-lived-under-stay-home-policies-most-last

⁵ NHS (2020) Anxiety Disorders in Children. nhs.uk/mental-health/children-and-young-adults/advice-for-parents/anxiety-disorders-in-children/

About the Author

Alexandra Schuur works as both an elementary school counselor and a part-time private clinical mental health counselor. She enjoys working with children and families in international communities, and although she is from the Netherlands originally, she is a third-culture kid herself. Providing counseling services is a true passion for Alex, and she takes great joy from watching her students and clients meet their mental health goals.

The views expressed in the articles in this magazine are not necessarily those of BAMBI committee members and we assume no responsibility for them or their effects. BAMBI Magazine welcomes volunteer contributors to our magazine. Please contact editor@bambiweb.org.