Patient education: Anxiety in children and teens (The Basics)

When is anxiety a medical problem? — Everyone feels anxious or nervous once in a while. And it's normal for children to have different worries or fears as they grow. But sometimes, a child or teen has lots of anxiety that doesn't go away and gets in the way of their life. This can be a sign of an anxiety disorder.

Children can have different anxiety disorders. These include:

●Generalized anxiety disorder

●Social anxiety disorder

●Panic disorder

●Phobias

●Separation anxiety disorder

All of these involve worry or fear. But depending on the disorder, these feelings are caused or "triggered" by different situations. For example, a child with social anxiety disorder might worry about embarrassing themselves in front of other people. A child with a phobia has an extreme fear of a specific thing or situation.

Generally, to be diagnosed with an anxiety disorder, a child needs to have ongoing symptoms for some amount of time. This is often defined as 6 months, but it depends on the disorder.

What are the symptoms of an anxiety disorder? — In general, the symptoms involve feelings of worry or fear that get in the way of normal life.

Children with an anxiety disorder might also:

●Feel restless, on edge, or irritable

●Try to avoid school or social activities

●Have physical symptoms, like headaches, dizziness, nausea or vomiting, chest discomfort, shortness of breath, or pain

●Have trouble sleeping

●Have trouble focusing in school

●Have trouble eating enough

●Have thoughts of hurting themselves

Depending on the anxiety disorder, different situations or places can trigger these symptoms or behaviors.

Some children have more than 1 anxiety disorder. Some have another mood disorder, like depression, as well as anxiety.

Will my child need tests? — A doctor or nurse can ask questions to help figure out if a child has an anxiety disorder. This is often done to "screen" for anxiety during regular checkups.

Screening includes questions about:

●The child's symptoms, how severe they are, and how often they happen

●Whether the child's anxiety gets in the way of their regular activities, like school or social events

You and your child might both be asked to answer questions. Depending on the answers to these questions, and how long the child has had symptoms of anxiety, the doctor might diagnose an anxiety disorder.

If the doctor thinks that another health problem could be causing your child's symptoms, they might do tests.

How are anxiety disorders treated? — Treatments include:

●Cognitive behavioral therapy ("CBT") – In this type of therapy, the child talks with a psychologist or counselor about what they think and do. Then, the counselor helps the child change how they see and react to their situation. This teaches them how to cope better with anxiety. For younger children, a parent or caregiver might participate in therapy, too.

●Medicines – Medicines used to treat depression can relieve anxiety, too, even in children and teens who are not depressed. The child's doctor or nurse will decide which medicines are best for their situation.

Children whose symptoms are more severe, or who also have depression, might have CBT and take medicines.

How can I help my child? — It might help to encourage your child or teen to:

●Move their body – Exercise can help many people feel less anxious.

●Limit or avoid caffeine – Caffeine can make anxiety worse.

●Find healthy ways to manage stress – For example, breathing or relaxation exercises might help.

●Eat a healthy diet – Eating plenty of vegetables, fruits, and whole grains can help with overall health.

When should I call the doctor? — Call for advice if:

●Your child's symptoms are getting worse, even with treatment.

●Your child's medicine is causing bothersome side effects.

●You are worried that your child or teen is using drugs or other substances.

Get help right away if your child is thinking of hurting or killing themselves! — Sometimes, people with anxiety disorder think of hurting or killing themselves. If your child ever feels like they might hurt themselves or someone else, help is available:

●In the US, contact the 988 Suicide & Crisis Lifeline:

•To speak to someone, call or text 988.

•To talk to someone online, go to www.988lifeline.org/chat.

●Call their doctor or nurse, and tell them it is an emergency.

●Call for an ambulance (in the US and Canada, call 9-1-1).

More on this topic

Patient education: Generalized anxiety disorder (The Basics)
Patient education: Social anxiety disorder (The Basics)
Patient education: Panic disorder (The Basics)
Patient education: Depression in children and teens (The Basics)
Patient education: Coping with stress (The Basics)
Patient education: Suicide prevention (The Basics)

Patient education: Depression in children and adolescents (Beyond the Basics)