Children's Anxiety Disorders & Treatment

It's normal for kids to feel anxious sometimes.

Children and youth can become anxious about school, social situations or family stresses from time to time.

But anxiety disorders involve more than temporary feelings of anxiety. More than 25 percent of youth ages 13-18 have an anxiety disorder, and almost 6 percent of youth in that age bracket experience a severe anxiety disorder.1 When someone has an anxiety disorder, the anxious feelings do not go away and can worsen to the point that the anxiety interferes with daily activities. This is when clinical intervention is warranted.

Types of anxiety disorders

There are different types of anxiety disorders in children, including generalized anxiety disorder, panic disorder and social anxiety disorder.¹

Generalized anxiety disorder in children – Generalized anxiety disorders are characterized by excessive worry about everyday problems for at least six months.² Generalized anxiety disorder symptoms in children may include restlessness, difficulty focusing on homework or assigned chores, irritability or sleep problems.²

Panic disorder in children – Children with panic disorder have sudden periods of intense fear that may include sweating, shaking, sensations of shortness of breath or a pounding heart, and a feeling of impending doom.²

Social anxiety disorder in children – Anxious feelings may intensify in social situations, especially if the child expects to feel embarrassed, judged or rejected. While many children may feel some degree of this, symptoms of social anxiety disorder include feeling self-conscious in front of other people, worrying for days or weeks before an event, avoiding social situations and having a hard time making and keeping friends.²

Does your child have an anxiety disorder?

Evaluation for an anxiety disorder often begins with a visit to a primary care provider. Some physical health conditions and medications can imitate or worsen an anxiety disorder. A thorough mental health evaluation is also helpful, because anxiety disorders often co-exist with other conditions, such as depression or obsessive-compulsive disorder.²

Treating children with anxiety disorders

Anxiety disorders are generally treated with psychotherapy, medication or a combination of both, but each of the treatments alone is effective.³ The most common anti-anxiety medications are benzodiazepines, beta blockers and antidepressants. Only an expert clinician can help you decide whether the medication is worth the risk of side effects. Your provider may try several medicines before finding the right one.

There are a number of things that a parent or family member can do. Pay attention, monitor the child closely for signs of worsening anxiety or an increase in nervousness, instability or other symptoms. Promote good health in other ways including adequate nutrition, sleep and exercise. Parents should promptly seek medical advice and evaluation if their child or adolescent experiences suicidal thinking or behavior, nervousness, agitation, irritability, mood instability, or sleeplessness that either emerges or worsens during treatment. Finally, educate others, teachers, activity leaders on the child's needs.

How to help your child with anxiety

Therapy is a great resource for children and families dealing with anxiety and mental health issues, but there are ways to help your child at home in addition to counseling. Some useful ideas may include:

• Let your child know you're there to listen to their feelings
• Try to eliminate stress when possible
• Stick to a routine
• Be flexible and accommodate your child's feelings
• Avoid punishment when your child regresses or has anxiety
• Celebrate progress

It's crucial to have the same expectations for a child with anxiety as you would for a child who does not have anxiety, though the routine or process surrounding stressful situations may differ.⁴ Talking about potentially triggering situations before they occur may help your child.

Children's anxiety related to traumatic events

Sometimes the most protected children are exposed to traumatic events, which can affect their mental well-being and cause temporary or lasting anxiety. In addition to therapy, parents can help children through these traumatizing events in several ways, including:⁵

• Remain calm and help your child feel safe
• Discuss the situation with your child, but leave out graphic details that may add to their anxiety
• Answer questions honestly, but give information on a need-to-know basis
• Avoid worst-case scenarios that may cause children stress or worry
• Encourage your child to talk about their feelings

Finding the right anxiety therapist for your child

While many therapists offer children's services, it's important to find the doctor or counselor best-suited to your family and your child's unique needs. Parents should look for a mental health professional who does not blame the child, the child's family or school, and instead works closely with the child's support system.⁶

Most importantly, it's important to listen to your child and observe how they react to therapy and upcoming therapy appointments. If there is any sense of hesitation, dread or anxiety linked to the appointment, or if your child does not trust or open up to the counselor, find a new provider who will make your child feel at ease and offer sufficient help.

Learn about the different types of mental health therapy, video chat live with a therapist for an introductory consultation, or visit Mental Health America for a comprehensive list of mental health support organizations and therapists in your area to help you find the care you need in seconds. Living a happier, healthier life is only a click away.

References

National Institute of Mental Health. Any Anxiety Disorder Among Children. https://www.nimh.nih.gov/health/statistics/prevalence/any-anxiety-disorder-among-children.shtml (accessed 3/31/16)

National Institute of Mental Health. Generalize Anxiety Disorder Among Children. https://www.nimh.nih.gov/health/statistics/prevalence/generalized-anxiety-disorder-among-children.shtml (accessed 3/31/16)

Walkup JT, Albano AM, Piacentini J, Birmaher B, Compton SN, Sherrill J, Ginsburg GS, Rynn MA, McCracken J, Waslick B, Iyengar S, March JS, Kendall PC. 2008 Cognitive-behavioral therapy, sertraline and their combination for children and adolescents with anxiety disorders: acute phase efficacy and safety. New England Journal of Medicine. 59(26):2753-66. (accessed 3/31/16)

Anxiety and Depression Association of America. Tips for Parents and Caregivers. https://www.adaa.org/living-with-anxiety/children/tips-parents-and-caregivers -(accessed 4/25/16)

Anxiety and Depression Association of America. Help Your Child Manage Traumatic Events. https://www.adaa.org/living-with-anxiety/children-and-teens/tips-parents-and-caregivers/help-your-child-manage-traumatic - (accessed 4/25/16)

Psychology Today. Finding a Great Therapist for Your Child. https://www.psychologytoday.com/blog/nurturing-resilience/201011/finding-great-therapist-your-child (accessed 4/25/16)