Anxiety in children is common and in some case a normal part of childhood development. It is normal to experience anxiety in response to new situations or uncertainty about upcoming events, especially where avoidance of situations that produce anxiety is much harder to escape (e.g., going to school). While Anxiety in children, adolescents and adults share common features, there are also important differences in how anxiety manifests and is expressed across different age groups. Here are some key distinctions between anxiety in children, adolescents and adults:
Expression of Anxiety
Younger children may not have the verbal skills to express or talk about their anxiety directly. Instead, anxiety may be expressed through physical complaints (e.g., stomachaches or headaches) or behavioral changes (clinginess, tantrums, avoidance). It is not uncommon for children to often say they don't feel well (e.g., stomach ache) to avoid various situations, with the most common situations avoided being day care, school or new environments.
Children's anxiety is often closely tied to their immediate environment, such as home or school. Separation from caregivers, academic stress, and social situations can be significant triggers. Peer relationships and social dynamics play a crucial role in childhood anxiety. Anxiety in children may manifest in school refusal, difficulty concentrating, and changes in behavior. Academic performance and social relationships may also be affected.
Common Types of Anxiety Disorders in Children and Adolescents
Generalized Anxiety Disorder (GAD)
Children or adolescents with GAD often worry about many things, such as:
(1) future events
(2) past behaviors
(3) social acceptance
(4) family matters
(5) personal abilities
(6) school performance
where symptoms may present as;
(1) worries about things before they happen (e.g., worries about friends, school, or self)
(2) constant thoughts and fears about the child’s or parents safety
(3) refusing to go to school
(4) frequent stomachaches, headaches, or other physical complaints usually anxiety related
(5) muscle aches or tension
(6) sleep problems
(7) clingy behavior with family members
(8) difficulty eating in the morning
(9) concentration difficulties where child or adolescent seems preoccupied with their own thoughts
(10) irritability, grouchy and inability to relax
All children and teens have some anxiety. It is a normal part of growing up. But sometimes worries and fears don’t go away. They may interfere with a child’s normal activities. In these cases, an anxiety disorder may be present. Make sure your child sees his or her healthcare provider for a consultaion of symptoms cause distress or interfere with daily home and school functioning.
Separation Anxiety Disorder
Intense fear or anxiety about separation from parents or caregivers especially when being dropped off at day care or school. This may be present in school refusal, staying overnight away from home or attending new places.
Symptoms of separation anxiety disorder often appear around three years of age when new challenges of leaving safe places present.
Common symptoms are:
(1) refusing to sleep alone
(2) repeated nightmares with a theme of separation
(3) worry when parted from home or family members
(4) worry about the safety of a family members
(5) school refusal (usually commences night before with extreme anticipatory anxiety)
(6) fearful about being left alone at school or daycare
(7) frequent physical complaints (e.g., stomachaches, headaches, or feeling sick)
(8) muscle aches or tension
(9) being clingy, even when at home
(10) panic or temper tantrums at times of separation from parents or caregivers
The symptoms of separation anxiety disorder may look like other health problems. Make sure your child sees his or her healthcare provider for a diagnosis.
Social Anxiety Disorder
Child and adolescent social anxiety (SAD) or social phobia (SP) consists of persistent fear and anxiety of social situations where negative evaluation and embarrassment may occur. The child or adolescent usually has an immediate fear response in social situations that often results in significant avoidance or distress. Social anxiety interferes significantly in the child or adolescents daily routine and may cause significant distress.
Childhood and adolescent social anxiety can be described with reference to three aspects:
Physiological symptoms
Children and adolescents may exhibit autonomic arousal in social situations, such as increased heart rate, sweating, flushing, nausea, abdominal problems, and muscle tension.
Behavior Symptoms
Social anxiety can be expressed as avoidance, irritability, angry outbursts, crying, clinginess, and overcautiousness. Also, children and adolescents with social anxiety are sometimes described by their parents as being overly sensitive to criticism and being non-assertive with peers.
Cognitive Symptoms
Children with social anxiety have many concerns about social evaluation and are likely to interpret social situations in a threatening manner, where peers or other children may evaluate of judge them negatively, resulting in anxiety and possible avoidance of these future social situations.
Treatment and Support
Cognitive-behavioral therapy (CBT) is often effective in treating childhood anxiety disorders. It helps children identify and change negative thought patterns and develop coping strategies and the ability to regulate powerful emotions like fear and anxiety.
Parental Support
Parental involvement and support are crucial. Understanding and validating the child's feelings, maintaining consistent routines, and providing a secure environment can help
School Involvement
Collaborating with teachers and school staff to create a supportive learning environment is important. This may include accommodating for anxiety-related challenges. If you suspect that a child is experiencing significant anxiety, it's advisable to seek the guidance of a mental health professional. Early intervention and appropriate support can help manage anxiety and improve the child's overall well-being.