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Posted: May 18, 2023

What is an anxiety disorder, and what does it look like in children?

By definition, an anxiety disorder can cause children to have:

– extreme fear,

– worry, and

– it could alter their overall behaviour, sleeping or eating patterns, and their mood.

Many children have fears and worries, and they may feel sad and hopeless from time to time. Strong fears may appear at different times during their development. For example, toddlers are often very distressed about being away from their parents, even if they are in a safe environment and are being adequately cared for.

Although fears and worries are typical in children, persistent or extreme forms of fear and sadness could be related to them having an anxiety disorder.

What are the different types of anxiety disorders in children?

Different anxiety disorders can affect children in different ways. These include:

1. Generalised Anxiety Disorder (GAD).

G.A.D. causes children to worry almost every day — and over a variety of things. Children with G.A.D. worry over things that most children worry about, like homework, class tests, or making mistakes.

However with G.A.D., children worry more, and more often, about these things, and over things parents might not expect would cause worry for them. For example, they might worry about play time at school or with friends, lunchtime, birthday parties, or travelling to school by bus. Children with G.A.D. may also worry about wars occurring around the world, the weather, what the future may hold for them, or about loved ones, their safety, potential illness, or the possibility of them getting hurt.

Having G.A.D. can make it hard for children to focus in school because there is almost always a worry on a child’s mind. It makes it hard for children to relax and have fun, eat well, or be able to fall asleep at night. They may miss many days of school because worry makes them feel sick, afraid, or tired.

Some children with G.A.D. keep their worries to themselves. Others talk about their worries with a parent or teacher. They might ask over and over whether something they worry about will actually happen. But it’s hard for them to feel okay, no matter what a parent says.

2. Separation Anxiety Disorder.

It’s normal for young children and toddlers to feel anxious the first time that they are apart from their parent(s). But after some time, they then get used to being with a grandparent, babysitter, or teacher, and then they start to feel comfortable in their surroundings.

However, when children do not outgrow this fear of being apart from a parent, it’s called Separation Anxiety Disorder. Even as they get older, children with this disorder feel very anxious about being away from their parent or away from home.

They may miss many days of school because of this fear, and may say that they feel too sick or upset to go. They may cling to a parent, cry, or refuse to go to school, go for sleepovers at a friend’s house, or other activities without their parent. At home, they may have trouble falling asleep or sleeping by themselves, or may avoid being in a room at home if their parent isn’t close by.

3. Social Anxiety Disorder (Social Phobia).

With Social Anxiety Disorder, children feel too afraid of what others may think or say about them. They are always afraid about what they might do, say something embarrassing, or worry that they might sound or look weird.

Children with this disorder don’t like to be the centre of attention at all. They don’t want others to notice them, and may avoid raising their hand in class for example. If they get called on in class to answer a question, they may freeze or panic and not be able to answer the question asked. With Social Anxiety Disorder, a class presentation or a group activity with classmates can cause extreme fear.

Social Anxiety Disorder can cause children to avoid school altogether or friends. They may feel sick or tired before or during school. They may complain of other body sensations that go with anxiety too. For example, they may feel their heart racing or feel short of breath. They may feel jumpy and feel they can’t sit still. They may feel their face get hot, or they may feel shaky and lightheaded.

4. Panic Disorder.

These sudden anxiety attacks can cause children to have overwhelming physical symptoms, such as feeling shaky or jittery, trembling, a racing heart rate, and shortness of breath.

Panic attacks can happen at any time, and they are more common in teens, rather than young children.

5. Selective Mutism.

This extreme form of social phobia causes children to be so afraid that they are unable to talk. Children with this actually can talk, and do talk at home or with their closest people. However, when they are at school, with friends, or in other places, they may refuse to talk at all.

6. Specific Phobias.

It’s normal for young children to feel scared of the dark, monsters, big animals, or loud noises like thunder or fireworks. Most of the time, when children feel afraid, adults can help them feel safe and calm again. But a phobia is a more intense, more extreme, and longer lasting fear of a specific thing.

With a phobia, a child dreads the thing they fear and tries to avoid it at all costs. If they are near what they fear, they feel terrified and are hard to comfort. On the other hand, with a specific phobia, children may have an extreme fear of things like animals, spiders, needles or shots, blood, throwing up, thunderstorms, people in costumes, or the dark.

A phobia causes children to avoid going places where they think they might see the thing that they fear. For example, a child with a phobia of dogs may not go to a friend’s house who has dogs, or to a park where there might be dogs there.

What Are the Signs & Symptoms of Children with Anxiety ?

A parent or teacher may see signs that a child is anxious. For example, a child might cling, miss school, or cry regularly. They might act scared or upset, or refuse to talk or do things. Children with anxiety also feel symptoms that others can’t see, such as feeling afraid, worried, or nervous.

Anxiety can also affect children’s bodies as well. They might feel shaky, jittery, or be short of breath. They may feel “butterflies” in their stomach, a hot face, clammy hands, dry mouth, or a racing heart.

These symptoms of anxiety are the result of the “fight or flight” response. This is the body’s normal response to danger, as it triggers the release of natural chemicals in the body. These chemicals prepare us to deal with a real danger, and they can affect a child’s heart rate, breathing, muscles, nerves, and digestion. This response is meant to protect us from danger, but with anxiety disorders, the “fight or flight” response is overactive, and can happen even when there is no real danger.

How Are Anxiety Disorders in Children Diagnosed and Treated?

Anxiety disorders can be diagnosed by a trained therapist. They talk with you and your child, ask questions, and listen carefully. They’ll ask how and when the child’s anxiety and fears occur most, which helps them to be able to diagnose the specific anxiety disorder the child might have.

A child with symptoms of anxiety should also have a regular health check-up. This helps make sure no other health problem is causing the symptoms being experienced.

Most often, anxiety disorders are treated with Cognitive Behavioral Therapy (CBT). This is a type of talk therapy that helps families and children learn how to manage worry, fear, and anxiety.

CBT teaches children that what they think and do, affects how they feel. In CBT, children learn that when they avoid what they fear, the fear stays strong, and does not go away. Instead, they will learn that when they in fact face their fear, the fear as a result begins to get weaker, and it eventually goes away.

In CBT:

Parents learn how to best respond when their child is anxious, and how to help them face their fears.
Children learn numerous coping mechanisms and skills, so they can face their fear full on, and worry less.

The therapist helps children practice, and gives support and praise as they try to overcome their fears. Over time, children will learn to face fears in the moment, which will help them to feel better. They learn to get used to situations they’re afraid of, and feel proud of what they’ve learned. Once children realise that without so many worries in their lives, they can then be in a mental space that allows them to focus on other things — such as their school work, activities, and having fun. Sometimes, medicines are also used to help treat children with anxiety, but this should be the last resort.

How Can Parents Help their Child who suffers from anxiety?

If your child has an anxiety disorder, here are some ways you can help them:

Find a trained therapist, and take your child to all the therapy appointments scheduled.
Talk often with the therapist, and ask how you can best help your child.
Help your child face his/her fears. Ask the therapist how you can help your child practice at home. Praise your child for efforts to cope with fears and worry.
Help children talk about their feelings, listen to them, and let them know that you understand, love, and accept them. A caring relationship with you helps your child build inner strengths, which will help them to overcome their anxiety over time.
Encourage your child to take small steps forward. Don’t let your child give up easily, or avoid what they’re afraid of. Help them take small positive steps forward.
Be patient. It takes a while for therapy to work and for children to start feeling better, and free from their anxiety disorder.