Can children suffer from anxiety?
When we talk about anxiety in children, it’s essential to remember that their feelings, much like those of adults, can range from normal nervousness to overwhelming distress.
Most kids will experience anxiety at various points in their lives, but some struggle with persistent feelings that can interfere with their daily activities. By understanding the signs and symptoms and common triggers, you can better support your child during these challenging times.
Signs and Symptoms
Children may express anxiety in several ways. It's important to recognise these signs, as they can be easy to overlook or misinterpret. You may notice:
Physical Symptoms:
Complaints about a “sore tummy” or headaches.
Increased heart rate or feeling shaky, especially before or during challenging situations.
Difficulty sleeping, which can manifest in trouble falling asleep or frequent nightmares.
Emotional Indicators:
Heightened irritability or emotional outbursts, possibly over seemingly minor issues.
Persistent worry about future events or imaginary scenarios that may seem out of proportion. Excessive clinginess, especially when faced with new experiences.
Behavioural Changes:
Withdrawal from social activities, such as avoiding friends or declining invitations.
School refusal or reluctance to participate in class.
Seeking constant reassurance from you or frequently asking questions about what to expect.
Each child may exhibit different signs based on their developmental stage. For example, younger children might display anxiety through clinginess or physical symptoms, while teenagers might express their worries through irritability or social withdrawal.
Common Triggers
Anxiety can be triggered by various factors in a child’s environment, experiences, and personal characteristics. Here are some common triggers you might recognise:
New Situations: Whether it’s starting a new school, attending a birthday party, or meeting new peers, unfamiliar environments can elevate anxiety. Many kids thrive on routine, and changes can unsettle them.
Separation from Caregivers: Being away from their primary caregivers can be distressing for infants and toddlers. As they grow, this can evolve into worries about safety when separated. For example, some school-aged children experience anxiety about their parents not being safe during the day.
Performance Pressure: Academic expectations can be a significant source of anxiety. Children who feel pressured to perform well, be it in sports, grades, or other activities, may experience heightened anxiety. They fear disappointing themselves, their parents, or their teachers.
Exposure to Media: With the prevalence of news and social media, children are more exposed than ever to frightening events, such as natural disasters and violence. These exposures can spark fear and worry about their safety and well-being.
Past Experiences: Traumatic events leave an imprint. Children who have experienced significant loss, bullying, or trauma may carry heightened sensitivity towards new experiences that remind them of those past incidents.
Parental Influence: Children often learn behaviours from the adults around them. If a parent is visibly anxious in certain situations, it's natural for a child to adopt similar attitudes, leading them to struggle with similar fears.
Understanding these triggers allows you to navigate your child's world more effectively. It’s common for parents to notice patterns; for instance, a child may become anxious every time a school holiday comes up, indicating dread over changes to routine or separation.
Creating an open dialogue is vital in response to these signs and triggers. Encourage your child to share their feelings and reassure them that it’s sometimes okay to feel anxious. This open communication is a foundation that fosters resilience, allowing your child to develop helpful coping strategies over time.
Lastly, keep in mind that while anxiety can feel overwhelming, it is manageable. With your support and understanding, along with a few proactive strategies, you can help your child navigate their vulnerabilities. In the following sections, we'll delve deeper into risk factors for childhood anxiety. Understanding these elements can further equip you to support your child's mental health and well-being.
Risk Factors for Childhood Anxiety
While there is no one cause of anxiety, understanding the various factors that can contribute to the development of childhood anxiety can equip you with the knowledge needed to support your child effectively. These factors can be broadly categorised into environmental factors and genetic predispositions. Let’s explore each in detail.
Environmental Factors
The environment plays a significant role in shaping a child's mental health, including their propensity for anxiety. Various environmental influences can increase the likelihood of anxiety disorders in children. Below are several factors to consider:
Family Dynamics: A chaotic or hostile family environment can set the stage for anxiety. Children who grow up in households characterised by high levels of conflict, such as constant arguments or a lack of emotional support, are more likely to exhibit anxious behaviours. An example can be seen in families experiencing significant stress, such as those dealing with parental separation or financial difficulties.
Parental Mental Health: If a parent is dealing with mental health issues, such as anxiety or depression, the risk of their children developing similar issues increases. Children may absorb their parents' emotional states, learning to mimic their fears and worries. Research indicates that poor parental mental health can lead to higher anxiety levels in children, reinforcing the need for parents to seek help when needed.
Educational Environment: The school environment can also contribute to anxiety levels. Children who face bullying, social isolation, academic pressure, or a lack of support from teachers may struggle with feelings of anxiety. Bullying can be a particularly significant factor, leading many children to feel unsafe or unwanted at school. Parents often notice changes in their children’s behaviour, such as reluctance to attend school or difficulties engaging with their work, signalling possible underlying anxiety.
Traumatic Experiences: Exposure to traumatic events such as violence, abuse, or the loss of a loved one can lead to long-lasting anxiety. These traumatic experiences can alter a child’s perception of safety in their environment. For instance, children who have undergone significant loss may show signs of anxiety whenever they face situations that remind them of their trauma.
Community and Societal Influences: Living in a high-crime area or in a community facing socio-economic challenges can foster a sense of insecurity and stress. Children growing up in these environments may internalise fears about their safety and future. Increased media exposure, particularly negative news coverage, can also exacerbate children's fears and anxieties. For example, parents might find their children more anxious after news reports about crime or disasters.
Recognising these environmental factors allows you to create a nurturing and supportive home environment. Providing stability and open communication can help mitigate many of these risk factors.
Genetic Predisposition
Genetic predisposition can also play an important role in the development of anxiety disorders in children.
Family History of Anxiety Disorders: If anxiety disorders, depression, or other mental health issues are present in your family, your child may be at a greater risk of developing anxiety themselves. Genetics can influence temperament and emotional responses, making some children more prone to stress from a young age.
Temperamental Traits: Some children are inherently more reactive or emotionally aware than others. Those with a temperament characterised by shyness or behavioural inhibition often exhibit more significant signs of anxiety. Research suggests that these traits can be passed down through family lines, reinforcing that your child's temperament may influence their susceptibility to stress.
Neurological Factors: Biological systems, such as neurotransmitter functioning and hormonal responses, can also affect anxiety levels. Research indicates that children with imbalances in neurotransmitters such as serotonin or norepinephrine may have a higher predisposition to anxiety disorder. Understanding that anxiety can have biological roots may help in fostering empathy and understanding towards your child’s experiences.
Interactions Between Genes and Environment: There is no one cause of anxiety. Research indicates that the development of anxiety can usually be attributed to the interaction between genetics and environmental factors. For instance, a child with a genetic predisposition for anxiety may only develop issues if they are exposed to significant environmental stressors.
In summary, the interplay between environmental factors and genetic predisposition can create a complex web of influences that shape your child's experience of anxiety. Recognising these risk factors can empower you to create an environment that fosters resilience and emotional strength.
As you navigate through understanding your child's anxiety, keep in mind that while these risk factors may exist, they do not determine your child's future. With proper support and strategies in place, there are a multitude of ways to tackle anxiety and promote healthy emotional development. It’s helpful to remain observant, engage in open conversations about feelings, and seek professional guidance if needed. Together, we can create a nurturing space for our children to thrive.
Impact of Anxiety on Children
As we've discussed the various risk factors contributing to childhood anxiety, it's equally important to understand the tangible effects this anxiety can have on children’s everyday lives. Anxiety is more than just feeling nervous; it can permeate various aspects of a child's experience, particularly their academic performance and social relationships. Recognising these implications helps parents and caregivers develop effective strategies to support anxious children.
Academic Performance
Anxiety can have a profound effect on a child’s academic life. While it's common for children to feel apprehensive about school, anxiety becomes a concern when it interferes significantly with learning and performance. Here are several ways unhelpful levels of anxiety can impact academic achievement:
Difficulty Concentrating: Children struggling with anxiety often wrestle with intrusive thoughts and persistent worries, making it challenging to focus on lessons or complete assignments. You might notice that your child frequently seems distracted or unfocused during homework time, even if they are sitting right at the table.
Avoidance Behaviour: Many anxious children may try to avoid school altogether, displaying behaviours like refusing to attend school. You may experience morning meltdowns or complaints of illness on school days as your child tries to escape the source of their anxiety. This avoidance can lead to gaps in learning and missed social interactions, further exacerbating their anxiety over time.
Test Anxiety: Situations that require performance, like exams and presentations, can be particularly anxiety-inducing. Children with anxiety may freeze or panic in high-pressure moments, which can impact their performance and grades, causing a vicious cycle of stress and poor academic outcomes. For example, a child might study diligently for a test but struggle to remember the material during the exam due to overwhelming anxiety.
Decreased Participation: Anxious children may shy away from classroom discussions or group projects, fearing judgment from peers. This self-imposed isolation can not only affect their learning but also their confidence in social settings. The lack of participation may result in missed learning opportunities.
Long-term Consequences: Over time, the cumulative effect of anxiety on educational experiences can lead to diminished self-esteem and a reluctance to engage in academic pursuits. Children may start to see themselves as ‘bad students’ or incapable of handling school responsibilities.
Seeking help during the early stages of anxiety may mitigate long-term impacts. Counselling, therapy and support can assist children to learn and use helpful coping mechanisms, enabling them to approach their academic journeys confidently.
Social Relationships
Apart from its influence on academics, anxiety can also affect children’s social interactions and relationships. Here's how stress can manifest in social contexts:
Social Withdrawal: Children experiencing difficulties with anxiety often isolate themselves, avoiding social gatherings like birthday parties, playdates, or even group activities at school. They may feel overwhelmed by the prospect of social interactions, leading to feelings of loneliness and sadness.
Difficulty Making Friends: Anxiety can hamper children's ability to form friendships. Kids might feel anxious about meeting new people or initiating conversations, leading to missed opportunities for social connections. The desire for friendships might be there, but anxiety can become a barrier.
Negative Peer Interactions: Anxious children may be more sensitive to peer teasing or rejection, exacerbating feelings of anxiety and loneliness. Their heightened awareness of social dynamics can make them feel like outliers or targets within their peer groups. For instance, a child with social anxiety might become overly upset by an innocent comment, leading to that moment impacting their self-esteem and willingness to interact with others.
Need for Reassurance: Many anxious children excessively seek reassurance from friends or parents, fearing negative evaluations or rejection. This constant need for validation can strain their relationships and may inadvertently burden their peers or family members.
Impact on Self-esteem: Social isolation and difficulty forming friendships can lower self-esteem. Children may believe they are unworthy of friendships or will permanently be excluded from social situations.
Building social skills is integral to overcoming these challenges. Encouragement, role-play scenarios, or seeking professional help can promote development in social engagement. Understanding the impact of anxiety on academic performance and social relationships equips you as a parent or caregiver to step in constructively.
Opening lines of communication with your child, offering explanations and some reassurance, and fostering opportunities for support are essential. In the upcoming sections, we'll discuss diagnosing anxiety in children, which will provide insight into recognising symptoms and when to seek professional help.
Diagnosing Anxiety in Children
Recognising anxiety in children can be challenging, especially since children may not consistently articulate their feelings effectively. Below, we outline some of the methods a healthcare professional may use to identify whether a child is experiencing difficulties with anxiety. Screening Tools and Assessment Methods
A variety of screening tools and assessment methods can help healthcare providers assess anxiety in children. These methods evaluate a child's symptoms, impact on daily life, and overall emotional health. Some widely used screening methods include:
Questionnaires and Self-Reports: Standardised questionnaires are often the first step in assessing anxiety. These can be filled out by parents, teachers, and the children themselves. Instruments like the Anxiety Disorders Interview Schedule for Children (ADIS-4) guide clinicians through a series of questions designed to understand a child's anxiety thoroughly.
Behavioural Assessments: These assessments provide a more practical observation of the child’s behaviour in home, school, and social environments. A child psychologist might observe your child in an educational setting, noting their interactions with peers and reactions to stress. It can be beneficial to keep a record of specific instances where anxiety manifests, which can be shared during assessments.
Structured Interviews: Conducting structured clinical interviews allows health professionals to have in-depth conversations about symptoms and feelings with children and their parents.
Parent and Teacher Feedback: Gathering input from parents and teachers can be extremely helpful. Teachers can often provide perspective on how the child's anxiety affects their behaviour in school and social situations. A teacher may also notice changes, like when a once talkative child suddenly becomes reluctant to participate in class discussions.
By using a combination of these tools, healthcare providers can develop a comprehensive view of your child's emotional state, identifying potential anxiety disorders effectively.
Diagnostic Criteria
Once screening tools have been employed, healthcare professionals will likely refer to established diagnostic criteria to determine if a child meets the requirements for a diagnosis of an anxiety disorder. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) guidelines are the most widely used criteria. Here are some of the diagnostic factors considered:
Duration of Symptoms: Symptoms of anxiety must persist for at least six months to be considered a disorder. Everyday childhood worries may come and go, but if anxiety is a consistent presence affecting daily activities, then it’s possible the child is experiencing an anxiety disorder.
Severity of Symptoms: The anxiety experienced must cause significant distress or impairment in functioning—this can be socially, academically, or in general daily life. For example, if your child refuses to go to school or engage in activities they once enjoyed, it may indicate a more severe condition.
Symptoms Must Be Excessive: The anxiety should be out of proportion to the situation. While it’s natural for children to feel nervous about new experiences, like starting school, it becomes concerning if that nervousness escalates to panic or avoidance behaviour.
Healthcare professionals may also try to gather information on whether the child manifests associative symptoms. The accumulated data will help them diagnose the specific anxiety disorder the child may be suffering from and determine the appropriate solution from there.
Associative Symptoms include:
Excessive worry about future events or situations.
Physical complaints like stomach aches or headaches that do not have a medical explanation.
Difficulty getting to sleep or staying asleep, often due to pervasive worrying.
Emotional distress, such as crying, tantrums, or frequent outbursts.
Various specific anxiety disorders may be diagnosed, including:
Generalised Anxiety Disorder (GAD): Characterized by pervasive and excessive worry about multiple activities.
Separation Anxiety Disorder: A child's excessive fear of being apart from primary caregivers.
Social Anxiety Disorder: Intense fear or avoidance of social situations due to fear of embarrassment or judgment.
Accurately diagnosing anxiety in children is important for providingsupport and helpful interventions. It often requires a combination of screening tools and clinical assessments to identify the unique symptoms and challenges your child might be facing. If you believe your child is struggling with anxiety, don’t hesitate to reach out to a healthcare professional like a GP who can facilitate this process.
The next section will focus on treatment options available for childhood anxiety. We'll explore the various therapeutic approaches, lifestyle adjustments, and when medication may be applicable. Understanding these options will prepare you to find the most appropriate solution to support your child's growth and emotional well-being.
Treatment Options for Childhood Anxiety
Effectively addressing anxiety can help your child regain confidence and improve their overall quality of life. Treatment methods typically fall into two primary categories: therapy approaches and medication options.
Therapy Approaches
Psychological therapy is often the first line of treatment for childhood anxiety. Counselling and therapy can give children the tools to recognise and manage their feelings. Here are some evidence-based therapeutic approaches:
Cognitive Behavioural Therapy (CBT): CBT is a widely-recognised treatment for various anxiety disorders. It focuses on identifying and changing negative thought patterns and behaviours associated with anxiety.
In a typical session, the therapist may guide your child in recognising irrational fears and developing coping strategies. For example, if your child feels anxious about speaking in class, a therapist might help them practice positive self-talk and gradually expose them to speaking situations.
Exposure Therapy: This specific form of CBT gradually exposes children to the situations or objects that trigger their anxiety. The idea is that, through repeated exposure, their fear will diminish over time. For example, if your child has social anxiety, a therapist may start with small group interactions and slowly increase the complexity of social situations as your child becomes more comfortable.
It can be challenging, but many children succeed with this approach and can learn to manage previously overwhelming situations. Under professional supervision, the exposure to the anxiety trigger is done in a safe environment where the children feel secure and supported.
Play Therapy: Play therapy can be particularly effective for younger children who cannot articulate their current state of mind. It allows children to express their feelings and experiences through play, their natural communication form.
A play therapist may use toys, games, and art to help children process their emotions. For instance, a child may act out their fears or anxieties using dolls or action figures, providing valuable insights to the therapist.
Family Therapy: Involving family members in therapy can be beneficial, as family dynamics often influence children's anxiety. It can make a child feel supported while navigating feelings and recounting experiences.
Family therapy encourages open communication about feelings and cultivates understanding of how individuals within the family, as well as the interactions they have with one another can support a child’s mental health.
Mindfulness and Relaxation Techniques: Incorporating mindfulness exercises and relaxation techniques into therapy can help children regulate their emotions. Techniques such as deep breathing, progressive muscle relaxation, and guided imagery have proven effective in managing anxiety symptoms.
Overall, therapy provides a constructive space for children to process their feelings and learn coping mechanisms that will assist them in managing anxiety throughout their lives. With the appropriate support from their family and health professionals, children can be equipped to manage their stress in the long run.
Medication Options
While psychological treatments often serve as the primary approach, medication may be considered in certain situations, mainly if the anxiety is severe or persistent. Medication can only be prescribed by a medical professional such as a GP, pediatrician, or psychiatrist. Psychologists cannot prescribe medication. If you are wanting to explore the option of medication, speaking with your child’s GP is a good place to start.
Effective treatment for childhood anxiety when the stress is severe or persistent. Can involve a blend of therapy approaches and, in some cases, medication. As a parent or caregiver, remaining engaged with healthcare professionals and being open to various treatment modalities can pave the way for your child’s recovery and resilience. You can navigate these challenges together, ensuring they feel loved, heard, and equipped to face the world confidently.
Meet Your Clinical Psychologists In Newcastle
Dr Emma Doolan is a Clinical Psychologist based in Newcastle. With a collaborative and evidence-based approach, she helps clients overcome various challenges such as anxiety, depression, stress, and trauma.
Emma is experienced in cognitive behavioural therapy (CBT) and other modalities like schema therapy, acceptance and commitment therapy (ACT), and compassion-focused therapy. She holds a PhD in clinical psychology and has completed her registration as a clinical psychologist from AHPRA. Emma is a member of several professional associations, including ACPA, APS, AACBT, and APN.
Paige Cornell is a clinical psychologist in Newcastle who has experience in therapeutic modalities such as Motivational Interviewing, CBT, Schema Therapy, DBT, and ACT. She focuses on building a solid therapeutic relationship and tailoring treatment to each individual. Paige has experience in private practice, NGOs, and forensic settings.
She works with a diverse range of mental health issues, including anxiety, mood disorders, PTSD, relationship problems, substance abuse, and offending behaviours. Paige is particularly interested in helping LGBTQI+ individuals and those dealing with trauma and substance abuse. She is fully registered and endorsed as a clinical psychologist and a board-approved supervisor for psychologists. Paige is a member of ACPA and APS, holding a Master's in Clinical Psychology and a Bachelor's in Psychological Science (Honours).
Taylah Armstrong is a Clinical Psychologist in Newcastle. She focuses on developing solid therapeutic relationships to assist individuals in enhancing their well-being and achieving their goals. Taylah is skilled in treating various concerns such as anxiety, stress, mood disorders, trauma, and eating disorders.
She utilises evidence-based therapies like CBT, DBT, and ACT. Taylah has worked in public healthcare, primary care, and education sectors. She is fully registered and endorsed as a clinical psychologist by AHPRA and holds a Master's and Bachelor's degree in Psychology from the University of Newcastle.
Paige Whitfield is a clinical psychologist in Newcastle with experience in private and public health settings. She collaborates with health professionals, families, and schools to provide evidence-based treatments like CBT, Narrative Therapy, and ACT for various issues. Paige has a Bachelor's degree in Psychology (Honours) and a Master's in Clinical Psychology. She is fully registered and endorsed as a clinical psychologist and is a member of APS and ACPA.
Dr Kaitlin Fitzgerald is a clinical psychologist in Newcastle who takes a collaborative and client-centred approach to therapy. She creates a warm and relaxed environment for clients, aiming to make therapy sessions comfortable and even enjoyable. Kaitlin holds a Doctor of Philosophy in Clinical Psychology and a Bachelor of Psychology (Honours) from the University of Newcastle. In addition to her private practice at ELD Psychology, she also works in public mental health treating adults with various mental health issues.
Kaitlin has experience working with a wide range of concerns, such as anxiety, depression, and relationship difficulties. She is skilled in evidence-based therapies like CBT, Schema Therapy, DBT, and ACT. Kaitlin is fully registered as a clinical psychologist with AHPRA and is approved to supervise provisional and registered psychologists.
Eliza Newton is a person-centred Clinical Psychologist dedicated to helping clients explore their deeper selves. She tailors her approach to each client, using psychodynamic therapy for self-exploration or structured techniques like Acceptance and Commitment Therapy, Cognitive Behaviour Therapy, and Schema Therapy. Eliza focuses on individuals overcoming childhood trauma, including Complex PTSD, and helps those with ADHD develop organisational and emotional well-being strategies. With experience in private practice, inpatient settings, and psychiatric rehabilitation, she addresses challenges from anxiety and mood disorders to severe mental illness.
Eliza holds a Bachelor of Psychology (Honours) from the University of Newcastle and a Master of Clinical Psychology from Western Sydney University. She is registered as a Clinical Psychologist with AHPRA and is a member of AAPi and ACPA.
Disclaimer
The content provided on this blog is intended for Australian audiences and is for informational purposes only. It should not be considered as professional psychological advice, diagnosis, or treatment. The information shared here is based on general knowledge and experience in the field of psychology, but it may not be applicable to your specific situation.
Always seek the advice of your psychologist or other qualified mental health provider with any questions you may have regarding a psychological condition or treatment. Never disregard professional psychological advice or delay in seeking it because of something you have read on this blog.
If you are in crisis or you think you may have an emergency, call your doctor, or dial 000 immediately. This blog is not intended to be a substitute for professional advice, diagnosis, or treatment.
The opinions expressed in this blog are solely those of the author and do not necessarily reflect the views of any affiliated organisations or institutions.