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Does Your Child Have an Anxiety Disorder?

Anxiety Disorders in Children

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Updated February 01, 2009

Anxiety disorders are common psychiatric illnesses that generally cause feelings of fear or distress in certain situations. Children -- even very young children -- are not immune to developing an anxiety disorder. If the symptoms are left unrecognized and untreated, young sufferers may experience academic difficulties, social and interpersonal problems and trouble adjusting to new life experiences.

Common Anxiety Disorders in Childhood

Panic Disorder. Recurring panic attacks are the hallmark features of panic disorder. Panic attacks are sudden and intense feelings of terror, fear or apprehension, without the presence of actual danger. A child with panic disorder may appear anxious or upset about being in certain situations or may have frequent physical complaints (i.e., frequent headaches, upset stomach) before or during certain feared activities. He or she may avoid or refuse to be in situations that he or she perceives as frightening due to the panic response. This may lead to the development of agoraphobia.

Obsessive-compulsive Disorder (OCD). Obsessions are repeated, intrusive, and unwanted thoughts or images. Compulsions are ritualistic behaviors that are difficult for the child to control. Examples of ritualistic behaviors may include counting, excessive hand washing, word repetition or a peculiar focus on arranging objects or personal items.

Separation Anxiety Disorder. Separation anxiety is thought to be a normal part of infant development. It begins when the child is about 8 old and declines after about 15 months of age. During this period the child understands the separation between self and primary caretaker. The child understands that he or she can be separated from the caretaker, but does not comprehend that the caretaker will return, which leads to anxiety. Separation anxiety disorder, on the other hand, is not a normal developmental phase. It is characterized by age-inappropriate fear of being away from home, parents or other family members. A child with separation anxiety disorder may be excessively clingy to family members, may fear going to school, or being alone. He or she may experience frequent physical complaints (i.e., headaches, stomach upset).

Social Anxiety Disorder. The features of social anxiety disorder include an excessive and unreasonable fear of social situations. If forced into a feared situation, the child may become upset and exhibit a temper tantrum. Children with this disorder may be extremely shy around strangers or groups of people and may express their anxiety by crying or be overly clingy with caregivers. The child may not want to go to school and may avoid interactions with peers.

Phobias. A phobia is an intensely irrational fear of a particular object (e.g., spiders) or situations (e.g., heights). If the child comes into contact with the feared object or situation, he or she may become very upset, anxious and experience panic attacks. Phobias can become disabling and interfere with the child’s usual activities.

Generalized Anxiety Disorder. Children with generalized anxiety disorder are overly anxious about routine everyday matters. They usually anticipate catastrophe or worst case scenarios in a broad range of situations. The chronic worry experienced by children with generalized anxiety disorder is unreasonable and irrational given the actual circumstances. Children with generalized anxiety disorder often have physical complaints that may include headaches, stomach upset, muscle aches and fatigue.

Signs and Symptoms

A child with an anxiety disorder may have physical complaints and/or odd or unreasonable behaviors. The following is a list of signs and symptoms that are often found in children with an anxiety disorder. It is often difficult to distinguish these signs and symptoms from certain medical or other psychological conditions or even normal stage development. This list is not meant to diagnose -- only a doctor or other qualified professional can diagnose a child with an anxiety disorder.

  • refusal or reluctance to go to school
  • decreased academic performance
  • extreme shyness or nervousness that is out of proportion with actual situations
  • difficulty, fear or avoidance of interacting with peers
  • odd rituals, such as excessive hand washing, counting, or arranging objects
  • fear of being away from home, parents or other family members
  • frequent crying spells
  • ongoing physical complaints that may include headaches, upset stomach, muscle aches or fatigue
  • trouble sleeping or nightmares
  • not wanting to sleep alone or fear of darkness
  • bedwetting
  • difficulty concentrating
  • irritability or frequent temper tantrums

This list is not meant to be all-inclusive. A child may have an anxiety disorder even if these signs and symptoms are not apparent. If you suspect your child has an anxiety disorder, seek professional advice.

Sources:

American Psychiatric Association. "Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision" 2000 Washington, DC: Author

Mental Health Association of Westchester. Anxiety Disorders – Children and Adolescents. MHA Westchester. 2008.

NationalAlliance of Mental Health. Anxiety Disorders in Children and Adolescents. NAMI. 2008.

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