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Everyone worries sometimes. If your child's worries cause severe distress and interfere with daily functioning — because they're refusing to go to school, for example — you may begin to wonder if your child's worrying is the sign of an anxiety disorder.

Every person occasionally suffers from anxiety, and that includes children. Is your child worrying that she'll get a bad grade on that important test? Is he scared he won't fit in at his new school? Is she terrified that evil character from the book she just read will appear on her way to the bathroom in the middle of the night? Is he worried the girl he has a crush on will not like him back? That is completely normal, unpleasant as it may be, and does not point to an underlying pathology. [1]

When anxiety in children takes the form of chronic, persistent worry that overshadows daily activities and hampers the child's enjoyment of life, however, you may be looking at an anxiety disorder. 

The Source Of Your Child's Worries Could Reveal What Anxiety Disorder They May Have

The term "anxiety disorders" can be seen as an umbrella, encompassing a spectrum of different but related mental illnesses. These include separation anxiety disorder, which accounts for around 50 percent of all cases of anxiety disorders in children [2], social anxiety disorder, obsessive compulsive disorder, specific phobias, and generalized anxiety disorder. [3]

The source of your child's persistent worries can give you valuable clues about the kind of anxiety disorder they may be suffering from. Here is a quick look at three of the more common anxiety disorders children get.
  • Children with separation anxiety disorder experience severe worries about being separated from their attachment figures, usually parents. This frequently results in the child's refusal to attend school or daycare and can lead to physical symptoms such as nausea and headaches. [4]
  • Children with social anxiety disorder worry about social situations, excessively fearing that others will not view them positively, that they have no control over the way they will act, that they have lacking social skills, and that challenging social interactions will lead to severely negative consequences. These children may come to avoid social situations as much as possible. [5]
  • Children with generalized anxiety disorder will worry about a great variety of things, ranging from health to academic or athletic performance, and natural disasters to misfortune befalling their loved ones. Young children with GAD will seek constant reassurance from others, while adolescents are more likely to "brood", constantly mulling their fears and worries over in their minds. [6]

I Think My Child Has An Anxiety Disorder: What Now?

Anxiety can be described as a natural response to danger — in other words, a functional emotion that allows humans and other animals alike to attempt to avoid detrimental outcomes. It is not pathological by definition, but becomes a problem where the anxiety begins interfering with a person's ability to carry out daily tasks, or where it becomes severe, ongoing, and excessive in relation to the sufferer's objective situation. Diagnosing pathological anxiety in children poses an added challenge, since this anxiety can often also be part of the child's normal development. A degree of separation anxiety in children is considered normative under the age of 30 months, for example. [7, 8]

Though a child's anxiety can cause them acute distress, it is possible that this anxiety is developmentally normative rather than pathological, in other words. We must also note that young children often lack the emotional vocabulary that would allow them to describe the symptoms they are experiencing, another obstacle on the road to accurate diagnosis. [9]

At the same time, it is important to be aware that research indicates that children who suffer from anxiety disorders are at an increased risk of suffering from anxiety and other psychiatric disorders in adulthood, particularly if childhood anxiety is left untreated. Timely intervention could, therefore, have implications beyond the goal of helping the child feel better at the present time. [10, 11]

Parents who believe that their child is suffering from excessive anxiety to the point that they may meet the diagnostic criteria for a childhood anxiety disorder are doing the right thing in taking their child for an evaluation.

Psychiatrists, psychologists, social workers, counselors, and nurse practitioners are all able to help. You will want to look for a mental health professional that has extensive experience in diagnosing and treating children with anxiety disorders, while being aware that psychiatrists and nurse practitioners are more likely to place a focus on pharmacological treatment. [see 1]

Treating Childhood Anxiety Disorders

Research indicates that cognitive behavioral therapy helps around 60 percent of children with anxiety disorders make a complete recovery, with success rates being higher in children who are not on the autistic spectrum. [12]

While the brain function abnormalities associated with childhood anxiety likewise improve with pharmacological treatment, such as SSRI antidepressants [13], we have to note that some antidepressants have been found to induce suicidal thoughts in children and adolescents [14]. As such, should your child be diagnosed with an anxiety disorder, it is prudent to weigh the pros and cons of anxiety medications carefully, in consultation with your child's clinician. 

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