A clap of thunder in the middle of the night sends the patter of little feet running toward your room. Or maybe an upcoming test has your child worried and on edge. Pretty standard stuff. A certain level of anxiety is normal and healthy. Every child has worries and fears.
But anxiety can become a problem if it interferes with your child's ability to participate in everyday life. Sometimes, it can get in the way of your child's ability to do well at home and at school, and to make friends.
When worries and fears take over, your child may need help understanding "false alarms." These are fear reactions to situations other children would consider nonthreatening. Your child may also need help learning how to work through these emotions.
Symptoms of anxiety
Childhood anxiety can take different forms.
- Generalized anxiety. Your child worries a lot, often about unlikely problems. Your child might feel tense or nervous, or as if something bad is going to happen. This may happen even when there are few reasons to feel this way.
- Social anxiety. Your child is distressed being around other people or strangers. Going to school can be a challenge.
- Separation anxiety. For some kids, this can remain an issue beyond the normal separation anxiety of the early toddler years.
- Panic disorder or a specific fear (phobia). This is less common in children, but it is possible.
Children with anxiety often have a hard time sleeping. Your child may talk about lying in bed for a long time without falling asleep, or about not being able to "turn off her brain." Some children may have difficulty falling asleep without a parent nearby.
Feeling overly fearful, stressed or worried may lead children to hold back from favorite activities. Some children will report frequent headaches or stomachaches, which can also be signs of an anxiety disorder.
Sometimes anxiety will spike during specific life events, such as a move to a different city or the loss of a loved one. National or international events, such as a pandemic, mass tragedies or war, can also send your child's anxiety into overdrive and require help.
When to seek help
If it seems like your child's anxiety is taking over his or her life, talk to your child's doctor. The doctor can check for physical health issues that might be contributing to your child's anxiety. Treating any underlying problems may help ease some worries.
A professional evaluation for childhood anxiety is based on questionnaires and real-time interviews the provider has with you and your child. The provider will ask about your child's symptoms and how they've affected your child and your family.
In some cases, the provider may refer you to a specialist in mental health conditions, such as a licensed counselor, psychologist or psychiatrist.
Treatment options
One of the most effective treatments for anxiety in children is a form of talk therapy called exposure therapy. Sometimes, medications are helpful, too.
Exposure therapy. A therapist gently guides your child through a series of exposures to a trigger that typically induces anxiety in your child. Over time, this process helps your child respond to the trigger in a healthier way.
For example, if your child is afraid of dogs, the therapist might begin by showing your child a picture of a dog. After a time, your child may practice petting live dogs. Or if your child has a social phobia, he or she might first practice talking to acquaintances, then strangers.
The goals of exposure therapy are to reduce feelings of anxiety and help your child learn to tolerate anxiety or discomfort. Exposure therapy may be done in an individual or a group setting.
Medication. Sometimes, your doctor may recommend an anti-anxiety medication. Selective serotonin reuptake inhibitors (SSRIs) may help ease symptoms.
Helping your child at home
Therapy can be very effective for kids with anxiety disorders. But you also can help your child at home:
- Build resilience. Help your child build resilience by learning to manage anxiety rather than always working to avoid it. Of course it's important to provide support for the big things: changing schools or friend problems. But removing all stress triggers or offering lots of reassurance about common issues can backfire. It can deprive your child of the chance to deal with anxious feelings.
- Test what's behind the fear. Encourage your child to test the reason behind his or her fear. For example, have your child ask, "What's the worst that can happen if I order directly from the server at a restaurant rather than asking mom or dad to do it?"
- Offer plenty of warm support. When your child is trying to face his or her fears, be available. Let your child express feelings without passing judgment or criticizing. Help your child see that most problems, even when they seem huge, are usually temporary or solvable.
- Maintain the basics. Adding structure to daily life can minimize worries about what's happening next and help your child feel more in control. Make sure your child gets enough sleep, eats regular nutritious meals, and has enough time for homework, chores and playtime.
Treatment approaches will have a better chance of success when your child is supported with warmth, consistency and stability at home and at school.
This information is adapted from "Mayo Clinic Guide to Raising a Healthy Child," edited by Angela C. Mattke, M.D., a pediatrician at Mayo Clinic Children's Center in Rochester, Minnesota.