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Anxiety
For Pediatricians

A Caregiver’s Guide to Managing and Treating Anxiety in Children and Teens

September 16, 2022

Is your child a worrier or struggling with something more serious? When your child is experiencing high levels of anxiety and stress, it can negatively impact nearly every area of their life. Explore Fort Health’s comprehensive guide to understanding anxiety, including warning signs and symptoms, the seven types of anxiety disorders, and when to seek out professional help — so you can restore your child to their best self.

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Between a 24-hour news cycle, social media, a global pandemic and increasing pressures around school and social life; you could not design a more anxiety-inducing environment for children if you tried.

It’s no surprise then that anxiety affects up to 1 in 5 children at some point in their lives and rates of anxiety symptoms have doubled since 2020.

The good news is that anxiety is well-understood and treatable.

This guide is a helpful overview covering:

  • What anxiety is
  • Anxiety types and symptoms
  • When anxiety may be a problem
  • How to help an anxious child yourself
  • Where and how to find more help

Looking to speak to someone about your child’s anxiety?
Book a free consultation with a Fort Health therapist today.

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1. What is anxiety?

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Anxiety is a term used to describe general feelings of worry or unease.

Anxiety is a normal part of life and can be helpful in alerting us to threats or driving us to achieve goals.

Our body’s response to fear is automatic and likely evolved out of the survival needs of our early ancestors living in perilous environments.

This automatic response can sometimes happen without the presence of real danger. Think of anxiety as the body’s alarm system being overly sensitive.

When these fears and stress reactions become disproportionate, uncontrollable or unreasonable, anxiety can become problemmatic.

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2. Spot the warning signs and symptoms of anxiety

Anxiety in children and teens can often show up as physical symptoms and behaviors. Some examples include:

  • Difficulty sleeping
  • Complaints of stomachaches, headaches or other physical problems
  • Avoiding certain situations
  • Clinginess around parents or caregivers
  • Trouble concentrating in class or nervous fidgeting
  • Tantrums
  • Being very self-conscious

Learn more about common anxiety symptoms in children and teens

3. When should I worry about my child’s anxiety?

While some anxiety is completely normal, it becomes a problem when a child or teen begins to avoid situations that trigger anxiety. When considering whether your child’s anxiety is a normal response to fears or a problem, look at three factors:

  1. Frequency: When irrational or disproportionate fears are experienced often and impact your child’s life on a daily basis.
  2. Duration: The time spent worrying is significantly longer than the time spent in the triggering situation, and your child struggles to get over the fear.
  3. Impairment: The anxiety interferes with normal child development, impacts relationships with family or friends, or prevents them from taking part in activities they enjoy.

If you notice anxiety occurring more often, for longer durations and causing more avoidance, it may be time to intervene.

4. Not every anxiety disorder is the same.

There are seven common types of anxiety that affect children and teens:

  1. Separation anxiety disorder: Children with separation anxiety become extremely upset when they are separated from their parents or caregivers. The distress that they feel is unusual compared to other children their age and they tend to struggle during times of transition.
  2. Social anxiety disorder: Children or teens with social anxiety are very self-conscious. They can find it difficult to hang out with peers or participate in class because they are fearful of rejection and may avoid particular places or groups of people.
  3. Selective mutism: Children and teens with selective mutism have a hard time speaking in some places, like at school. Their anxiety goes beyond typical shyness and isn’t about refusing to speak. Children with selective mutism can't speak even when they badly want to.
  4. Generalized anxiety disorder: Children with generalized anxiety disorder, also known as GAD, worry about a broad range of everyday situations.
  5. Panic disorder: Children and teens with panic disorder suffer from panic attacks. Panic attacks are scary and sudden surges of physical signs of anxiety, such as difficulty breathing and rapid heartbeat. Those experiencing a panic attack often feel like they are having a heart attack or “going crazy.”
  6. Obsessive-compulsive disorder: Children with obsessive-compulsive disorder, also known as OCD, experience unwanted thoughts, worries or called obsessions. They often develop impulsive, repetitive actions — called compulsions — to calm the anxiety caused by their obsessions.
  7. Specific phobia: Children and teens with specific phobias have extreme fears about a particular object, place or situation, such as darkness or dogs. These things aren’t typically considered dangerous but seem very scary to the child.

Learn how to identify and support your child in coping with seven common types of anxiety

5. Strategies to support your anxious child

When your child is anxious, it’s natural to want to help them feel better. But by trying to protect your child from the things that upset them, you can accidentally make anxiety worse.

The best way to help kids overcome anxiety is to teach them to deal with anxiety as it comes up.  This can include:

  • Practicing breathing and relaxation techniques
  • Planning ahead and talking through ways your child can deal with an anxiety-causing situation
  • Supporting your child as they learn to deal with their anxiety by praising their attempts to use coping skills
  • Modeling healthy ways of managing stress and anxiety yourself

With time and consistent practice, your child can learn to manage anxiety.

Get tips on how to help your child cope with an anxious situation

6. How to treat anxiety?

Almost all types of anxiety can be treated using cognitive behavioral therapy (CBT) CBT is based on the idea that our thoughts, feelings and behaviors all influence one another, and by changing the way we think, we can change how we feel and act.

CBT works to challenge negative thinking and reduce unhelpful behaviors. A therapist using CBT will guide the child in building coping skills, then begin to expose the child gradually to anxiety triggers in a safe and controlled manner.

This combination of skill building and gradual exposure helps the child or teen build confidence in their ability to cope with their anxiety so that they can do so independently.

For some children, taking medication for anxiety as prescribed by their doctor in addition to therapy makes treatment more effective.

7. Where can I learn more?

Fort Health is built with the Child Mind Institute, America’s leading nonprofit and authority on pediatric mental health.

Their website offers the most reliable and comprehensive resource for families looking to learn more about anxiety and dozens of other topics related to young people and mental health.

Visit https://childmind.org/topics/anxiety/

8. When and how to get more help

It may be time to seek more help for your child or teen’s anxiety if you’re noticing that their anxiety is:

  1. Getting worse: anxiety is triggered more easily or often and tends to last longer
  2. Interferes: anxiety interrupts their daily lives as well as your family’s routines
  3. Family History: if you have a family history of anxiety disorders there’s a higher likelihood that more help will be beneficial
  4. Leading to dangerous behaviors: some children or teens will attempt to cope with anxiety through substance use or other unhealthy behaviors

Book a free consultation with a Fort Health Therapist to learn how we can help your child cope with anxiety and get back to their best selves.

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