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How to recognize anxiety symptoms in your child

Life can be stressful, even if you’re a kid. From worries about school and social interactions to moving someplace new to a scary encounter with a big dog, it’s totally normal for children and teens to feel fretful or anxious about the world around them. 

A certain degree of anxiety can be a good thing, too. Just like with adults, the “fight, flight or freeze” response keeps kids alert to dangerous situations, and anxiety can provide a beneficial boost of energy or motivation to complete a school project or study for a big test. 

But when normal fears, worries or discomfort become extreme or chronic, your child may be suffering from an anxiety disorder. And because kids express their anxiety differently than adults, it may be hard to tell the difference between temporary angst and something more serious.


How common is anxiety in children and young adults?

Anxiety is the most common mental health disorder, and it’s become increasingly prevalent among children and teens over the last few years. By 2020, more than 5.5 million kids in the U.S. had been diagnosed with anxiety problems. According to the National Institutes of Health, nearly 1 in 3 adolescents ages 13 to 18 will experience an anxiety disorder. And those stats don’t even reflect the impact of a global pandemic that upended everyone and everything. 

 Research also shows that many kids with anxiety disorders go untreated. That leaves them at higher risk to perform poorly in school, miss out on important social experiences, develop behavior problems and depression, and abusing substances.


What are some of the symptoms of anxiety in children?

Signs of anxiety in kids can vary, but some of the most common symptoms include:

  • Difficulty concentrating
  • Trouble with sleep or nightmares.
  • Anger or aggression.
  • Excessive fear related to school, family, friends or activities.
  • Bedwetting.
  • Avoiding certain situations.
  • Appetite changes.
  • Fatigue and restlessness.
  • Complaints about physical symptoms, such as headaches, stomachaches and    
    muscle tension.
  • Irritability.
  • Social withdrawal.
  • Nervous habits, such as nail-biting.
  • Worrying about things before they happen.


What kinds of anxiety disorders can children and teens experience?

There are several types of anxiety disorders that can affect children and adolescents. Often, children can have more than one type of anxiety-related condition. Here are some of the most common:

  • Generalized anxiety disorder (GAD). GAD causes children to worry about a lot of normal, everyday things, such as grades, social interactions and performance in sports or other activities. Children with this disorder tend to be perfectionists and exceptionally hard on themselves.

    When should I be concerned? Symptoms have been present most days for at least six months and interfere with daily life.

  •  Separation anxiety. This type of anxiety causes kids to be extremely upset when separated from their parents or caregivers. 

    When should I be concerned? Symptoms have been present for at least four weeks.

  • Phobias. Children with phobias have an excessive fear of an object or situation that normally isn’t considered dangerous, such as animals or insects, water or heights, crowds or tight spaces, etc.  

    When should I be concerned? Phobias are disrupting your child’s life when they go out of their way to avoid what they’re afraid of.

  • Social anxiety disorder. Children with this type of anxiety feel extremely self-conscious around other people and are so afraid they avoid being in social situations or speaking up in class.

    When should I be concerned? Worry is so extreme that it interferes with daily life.
  • Panic disorder. Children with panic disorder have frequent, unexpected panic or anxiety attacks. They may experience physical feelings that can make them feel like they are dying or having a heart attack.

    When should I be concerned? Your child has experienced at least one panic attack and shows other symptoms, such as a constant fear of repeat panic attacks, or they have a significant change in behavior after panic attacks.
  • Selective mutism. Children with selective mutism have a high level of anxiety that it makes it exceptionally hard to speak only in certain situations, like at school or in some social settings. Only about 1 percent of children have this disorder.

    When should I be concerned? Your child speaks perfectly fine in familiar situations but freezes in others, and the behavior has been going on for more than a month.


How is anxiety in children different than in adults?

Children and adults share many of the same symptoms of anxiety, but there are some unique ways anxiety presents in children and teens. The biggest difference is how children recognize and express anxiety.

Children are still developing cognitive functions, which include mental abilities like learning, thinking, reasoning, problem solving and more. Because of that, they often don’t understand their anxiety or what’s causing it and have a more difficult time vocalizing their feelings. Instead, they may display a range of behaviors or physical symptoms that make it hard for parents and guardians to pinpoint what’s going on. Some anxious children may also keep their worries to themselves, so symptoms can be missed.

Some anxiety symptoms are more common in children than adults, such as:

  • Frequent nightmares.
  • Sleepiness or falling asleep at school.
  • Crying, irritability or tantrums.
  • Continual restlessness.

Separation anxiety is also more common in children, although it can also be diagnosed in adults.


What can I do to support my child with anxiety?

There are things you can do over time to help your child manage their anxiety and feel better about what’s going on. Here are a few strategies:

  • Identify triggers. Help your child recognize and become aware of what’s causing their anxiety.  Once you know their triggers, you can implement strategies to help ease their anxiety symptoms.
  • Respect what they’re feeling. When your child is anxious or upset, empathy and understanding can go a long way to make them feel heard and comforted.
  • Express positive and realistic expectations. Scary things are going to happen, so don’t promise they won’t. Instead, express confidence that they will be able to manage what comes their way.
  • Provide structure and predictability. Kids like routines. Try to stick to regular daily (and nighttime) routines when possible.
  • Teach them relaxation techniques. Deep breathing, meditation, progressive muscle relaxation and other mindfulness exercises have proven to be effective in helping children and adolescents manage their stress and anxiety.
  • Focus on healthy habits. Proper sleep, hydration, nutrition and exercise are huge plusses when it comes to managing your child’s anxiety. 
  • Monitor media use. Research shows that kids who log higher-than-average time on social media, TV and computers may show more severe signs of anxiety. 
  • Seek professional help if you’re worried about your child’s mental health and things aren’t getting better. Indigo virtual care is a great place to start. In most cases, you'll be able to schedule a same-day appointment.

Along with what you should do to help your child navigate their anxiety, there are also things you shouldn’t do. For instance, you should never try to:

  • Avoid things just because they make your child anxious. It may feel like you’re helping, and it may make your kiddo feel better in the short term, but accommodating your child will only reinforce their anxiety. 
  • Minimize what they’re experiencing. What your child is feeling is real. Telling them to “Just do it” or “Suck it up” isn’t helpful. Meet children with empathy, compassion and kindness.
  • Ask leading questions. Encourage your child to talk about their feelings, but avoid questions like, “Are your worried about the test/science project/soccer tryout?” A better approach is to ask them how they feel about a particular situation.
  • Reinforce their fears. While it’s important to validate your child’s feelings, that doesn’t mean you agree with them. Listen and show empathy when your child is fearful or anxious but encourage them to feel like they can face their fears.


Indigo is here to help 

If your child is struggling with anxiety, it may be time to get help. The great news is that anxiety disorders in children and adolescents are treatable. Early diagnosis is key to managing and controlling your child’s anxiety and keeping their symptoms from getting worse.

Indigo Virtual Care is a great place to start. Our Indigo clinicians not only treat your kiddo’s minor illnesses and injuries, but they can also help with their mental distress.

 During your face-to-face virtual visit, a clinician will:

  • Screen your child for anxiety and depression.
  • Complete a medical evaluation to determine if there are underlying physical reasons for their anxiety.
  • Offer recommendations around diet, exercise, sleep improvement and other lifestyle changes.
  • Prescribe medication, if needed, to ease anxiety symptoms.
  • Coordinate a referral to a mental health professional, if necessary.

Just like in-person care offered at our convenient neighborhood locations, Indigo Virtual Care is available 8 am to 8 pm, every day.

For children with mild to moderate anxiety, cognitive-behavior therapy (CBT) with a licensed therapist is typically the best method to treat anxiety-related disorders and help navigate anxiety symptoms. The therapy can help your child manage their anxiety by changing the way they think and respond in certain situations. 



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