It’s normal for children to have some worries and fears. But how much is too much? Dr. Alexa Ernst, a pediatrician at Atrium Health Levine Children's Rock Hill Pediatrics, shares the signs of anxiety disorders in children and teens and how to best support your child.
Signs of anxiety in children and teens
According to the Centers for Disease Control and Prevention (CDC), nearly 10% of kids between 3 and 17 have been diagnosed with an anxiety disorder. Dr. Ernst says there can be many signs of anxiety in children and teens, including headaches, stomachaches, aggressive outbursts, irritability and fatigue. These signs may also present in different forms, like:
- General anxiety: Worrying about something bad happening or about the future
- Social anxiety: Fear about being around other people, such as at school or other public places
- Separation anxiety: Fear about being separated from their parents
- Phobias: Extreme fear over a specific situation or thing, such as going to the doctor, bees or thunderstorms
- Panic attacks: Episodes of intense, sudden fear along with symptoms like sweating, shaking, dizziness, racing heart and difficulty breathing
“Teenagers are usually better at recognizing the feeling of anxiety and verbalizing it,” she says. “Younger children, however, do not always know how to recognize anxiety and this is when we can see aggressiveness or big emotions.”
Anxiety can also be a normal reaction to certain aspects of life — and that’s not always a bad thing.
“It can be common to have some anxiety around certain situations, such as an upcoming test,” says Ernst. “In this case, anxiety can be good because it will encourage the child to study for the test.”
Causes of anxiety in children and teens
There are many possible causes of anxiety in kids and teens.
“Big life changes can be associated with anxiety, such as moving, a divorce in the family and adverse childhood events,” says Ernst. “Genetics can also play a role. If parents have a history of anxiety, we can see this run in the family. And, sometimes, anxiety can almost appear out of the blue.”
How to support a child with anxiety
If you suspect your child or teen has anxiety, Ernst recommends talking to them about their feelings when they are calm.
“If there are certain situational factors that bring on anxiety, such as thunderstorms, it can be helpful to read a book about thunderstorms,” she says. “It is usually more beneficial to approach the topic when the child is calm and not in an anxiety-provoking situation.”
Try to put yourself in their shoes, understand their feelings, and validate them. Avoid labeling emotions as “good” or “bad” or telling them to “get over it.” Instead, encourage them to think helpful, supportive thoughts. For example, instead of, “I’m going to fail this test,” encourage them to think thoughts like, “I’ll study each day before the test and do my best.”
You can also encourage them to break big tasks into smaller, more manageable chunks that feel less overwhelming.
If they’re worried about something specific, like asking a friend to hang out, role-play with them to help them practice and feel more comfortable.
Finally, you can teach them deep breathing exercises, such as belly breathing, to help them calm down. For little kids, you can encourage them to breathe deeply like they’re smelling something good and then blow their breath out, like they’re blowing bubbles.
When to seek support for your child’s anxiety
If anxiety interferes with your child’s daily activities, Ernst recommends talking to their pediatrician. Contact your pediatrician if your child:
- Refuses to go to school or social activities
- Has a significant change in eating habits, such as not eating their meals
- Won’t participate in activities they used to enjoy
“Even if it hasn't gotten to this point, it’s good to mention your child’s anxiety at a wellness visit so it’s something your pediatrician will have on their radar for future visits and if it gets worse,” she adds.
Therapy is also a wonderful resource if you suspect your child has anxiety.
“I think everyone can benefit from therapy in some way,” says Ernst. “You don’t need to wait until someone ‘hits a breaking point’ per se to see a therapist. Especially in children who have been through big life changes, having a therapist to explore emotions and teach coping mechanisms can be really helpful. For younger children who may not verbalize as well, we can utilize play therapy.”
Atrium Health Levine Children’s Hospital is ranked among the nation’s best in behavioral health by U.S. News and World Report. If you are interested in learning more about the therapy resources in your area, talk to your pediatrician. Find a Levine Children’s pediatrician near you.
