By Dr. Karen Genachowski, PhD
You suspect your child is anxious, but what does that really mean?
Anxiety is an emotion that helps us identify possible threats and figure out how to stay safe. Just like all other emotions, such as happiness, sadness, and anger, everyone can expect to feel anxious some of the time no matter how old they are. However, sometimes children and teens can experience anxiety so intensely and so frequently that it gets in the way of having fun, doing well in school, or engaging socially with peers.
Recent trends show that 9.2% of children younger than 18 have been diagnosed with anxiety, and these rates are increasing. There are different types of anxiety and children and teens can experience multiple types of anxiety at once.
Not All Anxiety is Alike
Several common types of anxiety experienced by kids and teens include:
Separation Anxiety: When kids are fearful of separating from a caregiver because they worry that something bad might happen to themselves or the caregiver. For example, your teen may text you to check in frequently when you are in different places.
Social Anxiety: Occurs when kids have fear of judgment from others. For example, children or teens may avoid going to social gatherings with unfamiliar peers.
Selective Mutism: When kids have anxiety about speaking out loud in certain situations. For example, your child may speak freely at home, but stay silent while at school.
Specific Phobias: When kids have intense fear about specific situations or objects, such as animals, needles, or vomit. For example, a child with a needle phobia will likely experience intense fear in anticipation of doctor’s appointments.
Obsessive-Compulsive Disorder (OCD): When kids engage in rituals or behaviors (i.e., compulsions) in order to prevent or neutralize anxiety. This can look similar to other anxiety disorders. For example, a child with OCD may insist on a specific bedtime ritual, and become very upset if you skip a step or do not do something correctly or until it feels “just right.”
Generalized Anxiety: When kids have excessive worry that is difficult to control about a variety of concerns. A teen with generalized anxiety may seem on edge frequently, and may ask a lot of questions about future events.
Spotting the Signs of Child Anxiety
Anxiety in children and teens can also look different, or have slightly different symptoms compared to anxiety in adults. This can make it tricky for parents to spot.
Here are 6 signs your child may be experiencing anxiety:
Your child avoids certain situations consistently. They may have difficulty trying new things or flat out refuse to try new experiences. Avoidance is a hallmark of all anxiety disorders. For example, a child with separation anxiety will avoid separation from parents by being very clingy beyond what is expected for their age or developmental level. Or, they may be inconsolable when separated from a caregiver. They may follow you around the house, refuse to go to school, or have difficulty sleeping independently. A child with social anxiety will avoid going places with unfamiliar people, and a child with selective mutism will be unable to talk to their teacher, classmates, or caregiver.
Your child asks for reassurance. They may ask you numerous questions or ask you to double check something over and over again. For example, a child with generalized anxiety may ask you to explain all the details about what to expect for your upcoming weekend plans. After you explain once, they may ask again soon after. A child with OCD might ask you to repeatedly check that the door is locked before going to bed. In separation anxiety, your child may call or text you repeatedly. It may feel like no amount of explaining, checking, or answering the phone will keep them calm for long.
Your child appears restless. They may engage in repetitive movements, like bouncing their legs or feet, or picking at skin on their hands or face. They often seem tense or on edge. Heightened anxiety leads to a “fight, flight, or freeze” response, which involves a release of hormones that contributes to physical symptoms of anxiety.
Your child is often irritable or seems to overreact when something doesn’t go their way. Just like adults, when a child feels on edge much of the time, they can have a short temper. This might look like snapping back when you ask a question, being quick to anger or annoyance, or crying when something happens unexpectedly.
Your child engages in problematic behavior. When children feel nervous, this emotion may show up as troublesome behavior, such as not following directions, saying unkind words, or aggression. Children and teens are still learning how to express emotions, and this can be especially tricky with anxiety. In separation anxiety, a child may refuse to brush their teeth or throw a full-on tantrum at bedtime. A child with generalized anxiety may say unkind words about an upcoming family trip (e.g., “This trip is stupid! I don’t want to go!’). Though at face value it seems they are being rude, their behavior may reflect that they are feeling nervous about the travel or the events you have planned.
Your child has difficulty sleeping or eating. Worries might make it hard for them to fall asleep, stay asleep, or stay independently in their room at night. They may complain of nightmares. Anxiety can also contribute to an increased or decreased appetite. They may complain of stomach pain that makes it difficult to eat.
If you have a child or teen who is experiencing some or all of these symptoms, therapy might be a good option for them. Participating in therapy can help your child learn coping skills to face their fears so that anxiety no longer gets in the way of activities that are meaningful. Therapy can also help parents learn skills for how to support their child when they are feeling anxious, as well as to support them in facing their fears. Even if you’re not quite ready to have your child start therapy, understanding more about your child’s anxiety is a great first step.
Dr. Karen Genachowski, PhD
Karen Genachowski is a clinical psychologist at Old Town Psychology. She utilizes a cognitive behavioral approach in therapy with children, adolescents, and adults. She also conducts psychological assessments.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.)
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