Anxiety in children

Anxiety and fears in children: here’s what you need to know

By Anna Smyth, Clinical Psychology Registrar at Spencer Health 

Anxiety in children is often a normal part of life — we all experience anxiety from time to time. But, for some kids, excessive worrying may interfere with their daily lives. In fact, anxiety has become an increasing problem for many young people. According to health reports, anxiety is the second most common disorder in children (6.9%) and the most common among girls (6.1%). 

Find out what anxiety is, how to know if your child needs support, and where to get help. 

What anxiety? 

Anxiety is our body’s way of alerting us to a threat or a perceived threat. A healthy amount of anxiety is normal. If humans didn’t have this alert system, our species wouldn’t have survived, as we wouldn’t have known to run away from a bear (flight response) or combat an attacking animal (fight response). 

This fight-or-flight response is a release of hormones that helps you gather energy and focus to deal with a potential threat. This causes some physical sensations, such as ‘butterflies’ in your stomach, sweating, and your heart rate and breathing getting faster. This is because blood gets pumped around your body more quickly to the muscles that may need them, such as your arms and legs. Your blood is diverted away from your stomach and organs that aren’t needed at the time. 

It’s when this anxiety is present, without a stressful situation, or excessive and uncontrollable, that it becomes more problematic and negatively impactful on daily life.

What are the signs of anxiety in children? 

Anxiety in children can present in lots of different ways, depending on each child. 

Some common signs of anxiety in children include big emotions and not being able to manage them alone, or feeling overwhelmed by everyday situations. 

Physical symptoms are common too. These can be easily missed or dismissed as other medical issues. They may include stomach aches, headaches or trouble sleeping, including difficulty falling asleep or staying asleep. 

Cognitive signs may be that your child lets you know they are worrying a lot about different things or having nightmares. 

Behavioural signs may be fearing or avoiding outings or activities, or being overly clingy with a parent. Other signs can include fidgeting often, not eating properly, or being quick to anger.

How do I get a diagnosis for my child’s anxiety? 

Anxiety can be diagnosed by a GP, paediatrician or psychologist. Discuss your concerns with your GP or paediatrician, who can then decide if seeing a psychologist would be beneficial. 

A psychologist may conduct a formal assessment. This will help determine which line of treatment may help and what type of anxiety your child may be struggling with, such as generalised anxiety, social anxiety, or separation anxiety. 

If your child is dealing with a normal level of anxiety, management strategies can still be discussed with a psychologist. The psychologist will develop a full treatment plan if an anxiety disorder is identified.

What causes anxiety in children?

Many different factors can cause anxiety in children. It is thought that a combination of genetic and environmental factors play a role. Anxiety can be triggered by a build-up of stressful life situations. This may include stress at school, in friendships, between family members, or trauma as a young child. 

Currently, the unpredictable COVID-19 pandemic has increased anxiety levels in children. 

Anxiety can also occur simply because someone has a genetic predisposition to it, including a family history of anxiety or other mental health issues. Certain personality traits, such as shyness or behavioural inhibition, can be precursors for anxiety. 

Certain medications may increase symptoms of anxiety, and medical disorders such as thyroid issues can alleviate anxiety.

How is anxiety in children treated? 

Anxiety can be treated in a number of ways. It can be managed with extra support from psychologists, teachers and parents. The most common way to treat anxiety disorders in children is through the use of Cognitive Behaviour Therapy (CBT) with a psychologist. 

CBT is a structured psychological treatment that focuses on how our thoughts (cognitive) and behaviours can impact our emotions and how we feel. Cognitive techniques to help anxiety include determining our automatic negative thoughts and worries and finding ways to challenge them. Different types of unhelpful thinking styles (e.g. catastrophising) are identified, and helpful thoughts are taught to replace unhelpful, negative thoughts. 

Breathing strategies can be taught to children to resolve physical symptoms of anxiety, such as a faster heart rate and breathing. Children can also learn coping strategies and be gradually reintroduced situations or places that are avoided because they are feared. 

Medication can be a helpful aid in managing anxiety disorders for certain children. These can be discussed with a medical professional (GP or paediatrician).

How can I help my child’s anxiety? 

There are a number of ways parents can help their children when they are feeling anxious or overwhelmed. Firstly, developing a child’s emotional literacy is important so they know how to name their emotions and express how they are feeling. You can also ensure you don’t to shut down your child’s emotions or try to fix it, but to validate their feelings and making them feel safe in expressing them to you.

Explaining what anxiety is and why it happens can also be helpful. This can be done through the help of educational videos, including this one that explains the Fight-Flight-Freeze response.

 

Exercise and a balanced diet have been found to be helpful with anxiety disorders, so ensuring your child gets their body moving in ways they enjoy, and eats good nutrients can be highly beneficial. Modelling healthy ways that you manage your own stress and anxiety can be helpful if your child has anxiety. For example, if your child notices that you are giving a presentation at work, and that you practise at home and do some breathing exercises, they may mirror this helpful behaviour.

How can I get support for my child’s anxiety? 

Early intervention is key in managing anxiety in children. If you or your child’s teacher notices signs of anxiety, book an appointment with your GP or pediatrician to discuss options and for them to help you find a suitable psychologist or mental health professional. 

Currently, your child might be able to access Medicare rebates for up to 20 mental health services from a psychologist each calendar year. These can be obtained through a referral from your GP.

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