Children with Mental Health Disorders: Anxiety

Many children experience fears; these are developmentally normal. Children with anxiety disorders¹ have fears and anxieties that are persistent. These disorders create symptoms that can last for months. Anxiety levels and types of anxiety may vary.

Anxiety is the number one mental health issue for children and occurs in about 10% of children and is more frequently seen in girls than boys.  Anxiety disorder is diagnosed when the anxiety makes it hard for children to live their daily lives with family and friends, at home and at school.

Children with Generalized Anxiety Disorder (GAD)

Description

Anxiety in children can involve thoughts, feelings and behaviors.

Common symptoms of anxiety in children may be:

• Worries;
• Requests for reassurance;
• Frequent “what if” questions;
• Upsetting, obsessive thoughts (see full Glossary);
• Clinginess or difficulty separating for parents;
• Avoiding situations with some risk, for example, going swimming;
• Tantrums when faced with fears;
• Freezing or mutism (see full Glossary) in fearful situations;
• Repetitive rituals (compulsions) (see full Glossary);
• Panic attacks (see full Glossary);
• Hyperventilation (see full Glossary)
• Stomachaches;
• Headaches;
• Insomnia (see full Glossary)
• Tic disorders may also accompany anxiety. Tics are sudden, involuntary (not done on purpose), and often meaningless movements and sounds.

To find out quickly if a child may have signs of anxiety disorders, four questions are often useful:

1. Does the child worry or ask for parental reassurance almost every day?
2. Does the child consistently avoid certain age-appropriate situations or activities, or avoid doing them without a parent?
3. Does the child frequently have stomachaches, headaches, or episodes of hyperventilation (see full Glossary)?
4. Does the child have daily repetitive rituals (see full Glossary)?

Although younger children can show signs of excessive worry, children usually develop GAD at about 12 years old. Almost half of children with an anxiety disorder will continue to suffer from an anxiety problem when they are adults. Many children with generalized anxiety disorder also have other anxiety problems. The most common problems are social anxiety, depression, separation anxiety, and attention-deficit hyperactivity disorder (ADHD). 

Intervention Options

Depending on the level of anxiety the child experiences, intervention options may vary.

For a child with mild to moderate anxiety, cognitive behavior therapy (CBT) (see full Glossary) is helpful, particularly when done with the parents and family. CBT involves counseling the child and his or her parents on these topics:

• Keeping things in perspective;
• Soothing activities;
• Modeling effective coping;
• Helping child understand the difference between thoughts and actions (for obsessions);
• Relaxation techniques and deep breathing;
• Occupational therapy (OT)  to foster physical, and mental health and well-being;
• Group support to foster social skills.

Psychotherapy (see full Glossary) may also be required.

1 Reference:
Manassis, K. (2004). Childhood anxiety disorders, Approach to intervention.