Anxiety in Children

Every child has worries and fears in varying degrees. Some are a normal part of childhood and growing up, while others are not. Along the way, it is the role of parents to reassure their child and keep a healthy dialogue to support them to feel secure, heard and safe as they grow and mature in life to “conquer” their day.

DR. NINA’S WHAT YOU NEED TO KNOW: About Anxiety in Children

We teach our children to fear running into a busy street, approaching unfamiliar dogs, accepting candy from strangers, and on it goes. In these instances, we’re teaching our children caution and to fear the results. These are very different situations from dealing with a child who is responding with excessive worry or to an imaginary fear rather than a real danger.

And, certain fears and worries are typical for specific age groups. For example, young children are often afraid of loud noises, darkness, imaginary figures and separation; while in adolescence, social concerns, fearing the future or rejection is more prevalent.

Phases are generally temporary and usually harmless. However, children who suffer from an anxiety disorder experience excessive or persistent fears, worries, nervousness, shying away — and may want to avoid places and activities.

Symptoms:

• Emotionally manifested as irritability, restlessness, anger, inability to focus (may be mistaken as attention-deficit hyperactivity disorder), easily startled, cry-worrying, seeking perfection, clinginess, throws tantrums, difficulty sleeping, reluctance/refusal to go to school.
• Physical symptoms include head or stomach aches, racing heart, rapid breathing, sweating, or muscle tension.
• Toddlers may develop separation anxiety which reflects an understanding of object permanence (objects continue to exist even when they can no longer be seen or heard). Considered normal, however, it can become a problem if they become very anxious or upset when separated from an attachment figure (i.e. parent, caregiver); refuse attending playdates; or, perseverate that bad things will happen to them or their loved ones while separated.
• During adolescence, social anxiety or a strong fear of social situations, being very self-conscious around others, demonstrating fear of school or places, or excessive worry about being embarrassed or judged. In some, children may develop selective mutism, not speaking in social situations.
• Characterized by excessive, exaggerated anxiety, fear and worry for an extended time, Generalized Anxiety Disorder (GAD), is when daily life/events become an ongoing state of worry, fear or dread.
• Specific phobias are an excessive, irrational fear of an object or situation. The child avoids/dreads it, or in some cases, endures it, but with tremendous discomfort (i.e., going to doctor’s office, heights, certain animals, or insects).
• Panic disorder is when there are repeated episodes of sudden, unexpected, intense fear and discomfort that is accompanied by physical symptoms of a pounding heart, difficulty breathing, shaking, loss-of-control, sweating, and dizziness.
• Obsessive-compulsive disorder and posttraumatic stress disorder (PTSD) fall under the umbrella of anxiety disorders

Anxiety Vulnerability: Anyone can develop an anxiety disorder, if anxious thoughts and feelings are excessive or linger longer than they should. However, there is an increased risk due to these factors and while there is much more to be learned, what we do know is that:

• Biological: Special chemicals in the brain, called neurotransmitters, send signals and messages and control the way a person feels. When dopamine and serotonin—two important neurotransmitters—are off-kilter, feelings of anxiety can manifest. And, too, certain medical conditions such as heart murmurs or low blood sugars, as can be seen in diabetes, can trigger anxious feelings.
• Environmental: Parents or family members who are anxious, stressed, or have high—perhaps unrealistic expectations—can contribute to a child’s anxieties. And, too, stressful events such as divorce, the loss of a parent, family death, moving, being bullied, or starting a new school. Additionally, it can be a side-effect of a medicine such as asthma inhalers.
• Behavioral: Coping skills and learned behaviors, such as allowing the child to miss school when they are anxious about going, likely causes the child to feel more anxious the next school day. Or, too much screen time, not drinking enough water, lacking physical activity, not getting adequate sleep, or poor eating habits.

Empathize with your child’s worrisome thoughts and feelings which helps to normalize their experience while providing the understanding they aren’t alone, you’re with them – and will help guide them through it. As they mature, ensure they understand the importance of managing anxieties and stress in life – including balance, restful/restorative steps, getting quality sleep, eating healthy, being active, recognizing the positive and maintaining healthy boundaries.

Dr. Nina Radcliff is dedicated to her profession, her patients and her community, at large. She is passionate about sharing truths for healthy, balanced living as well as wise preventive health measures. 

She completed medical school and residency training at UCLA and has served on the medical faculty at The University of Pennsylvania. She is a Board Certified Anesthesiologist. Author of more than 200 textbook chapters, research articles, medical opinions and reviews; she is often called upon by media to speak on medical, fitness, nutrition, and healthy lifestyle topics impacting our lives, today.