It’s perfectly normal for your children to feel anxious occasionally. They may be nervous about an upcoming test at school, worried about who they’ll sit with at lunch, apprehensive about a change in their routine or stressed about a situation at home. But, anxiety in kids and teenagers doesn't always look how you'd expect.
“Younger children especially have a harder time expressing how they feel, so they may often complain about physical symptoms like stomachaches or headaches, cling to their parents during drop-off at daycare or school, display excessive hyperactivity or lash out with temper tantrums,” says Dr. Steven Sehr, medical director at Wellmark Blue Cross and Blue Shield.
If you notice one or two of these signs every so often, it’s likely nothing to worry about — everyone has off days. But, if your child appears to be struggling daily with multiple signs of anxiety, it may be time to see a mental health professional about the possibility of a chronic anxiety disorder.
What is an anxiety disorder?
According to the Anxiety and Depression Association of America (ADAA), the term “anxiety disorder” Opens PDF groups together several mental health conditions, such as obsessive-compulsive disorder, panic disorder, generalized anxiety disorder, social anxiety disorder, post-traumatic stress disorder, and specific phobias. And, children are not immune from these conditions and other mental health struggles. Anxiety disorders affect one in eight children, according to the ADAA.
Anxiety disorders in children often develop after stressful life changes or events, like the loss of a loved one or switching schools. Though they can be hereditary, it’s rare to see a purely biological mental health condition in children, especially younger children. “Much of the time, what we see going on in kids are responses to their environment,” says Dr. Sehr. “Every child has a different level of resiliency to stressful situations.”
Signs of anxiety in children
Anxiety in kids and teenagers can present itself in many ways. The main difference between anxiety and an anxiety disorder is that one is a temporary phase that goes away and the other is persistent and constantly interfering with how your child functions day-to-day. While anxiety can usually be addressed with reassurance and comfort about a situation, an anxiety disorder cannot.
Some physical signs of anxiety in children include:
- Headaches or stomachaches with no medical cause
- Refusing to eat at school
- Appearing restless, fidgety or distracted
- Difficulty falling asleep
Some emotional signs of anxiety in children include:
- Increased sensitivity
- Fear of making minor mistakes
- Worrying about far-off situations
- Frequent nightmares about loss
Some behavioral signs of anxiety in children include:
- Refusing to go to school
- Avoiding social situations with other kids
- Increased meltdowns or temper tantrums
- Constantly seeking approval for actions
If you’ve noticed a few of these signs recently, start a journal to keep track of your child’s behavior. This can help you find patterns and determine if there are situations that might be leading to certain behaviors or causing some anxiety.
If the anxious behavior goes on for longer than two weeks, or your child begins avoiding activities they once enjoyed, consider reaching out to your child’s doctor with your concerns. “Sometimes kids don’t want to go to school for a day or complain of having a stomachache a few days in a row,” says Dr. Sehr. “But if the behavior starts to impact your child on a regular basis, or physical symptoms become so frequent that it limits their time in school or other activities, it’s normal to seek professional help to resolve your child’s anxiety.”
How are anxiety disorders in children treated?
Luckily, anxiety disorders in children can be easily treated once diagnosed. Cognitive-behavioral therapy is often the first treatment to try before starting any medication, and it’s important for parents to be supportive during the treatment process. You may want to consider a therapist who has post-graduate training or special certifications in therapy for young children, like play therapy or art therapy.
Just like with any treatment, patience is key. “You don’t usually see the benefits of therapy right away,” says Dr. Sehr. “If a child has anxiety or depression, you’ll start to see improvement within six to eight weeks.”
Whether you choose therapy or medication, seeking treatment for your child’s anxiety disorder is important. “Chronic, untreated anxiety or depression in a young child can lead to delayed development of social skills, language skills and academic capabilities,” says Dr. Sehr. “It can really affect kids if they’re unable to pursue their normal daily activities.”
Know your options and resources for treatment
If you’re concerned about your child’s anxious behavior, you can talk to their pediatrician for their recommendations before deciding how to — or if you should — move forward with treatment. You can also use the following resources for help:
- myWellmark®: Wellmark members can log in to or register for myWellmark Opens New Window to find a nearby mental health provider who is in-network.
- Doctor On Demand®: If your child feels more comfortable opening up to a doctor while they’re at home, a virtual visit may be an option. Doctor On Demand is a covered benefit under many Wellmark Blue Cross and Blue Shield health plans — all you have to do is download the app or visit the website External Site to create an account.
- BeWell 24/7SM: For quick questions — “Is this behavior normal?” — you can connect with a real person, day or night (when we say 24/7, we mean it!) for answers. Just call Eight, Four, Four, Eight, Four, Be Well.
Remember: Many symptoms of anxiety in kids and teenagers can look like normal behavior, so it can be a challenge to determine if your child is just going through a phase or experiencing anxiety. But, you know your child best. If they have been acting "off" for more than a week or two, have complained of physical ailments, and have seemed extra irritable or upset lately for seemingly no reason, it may be time to consult a health care professional.
