Most people tend to associate anxiety disorders with adulthood. After all, it’s the time of life when you have to deal with unforgiving deadlines, relationship problems, and that dishwasher that just keeps breaking. But while childhood may seem considerably more carefree, that doesn’t mean kids are free from the weight of anxiety disorders. Quite the opposite, in fact.
“Many people don’t get diagnosed with an anxiety disorder until they’re an adult,” says Gail Saltz, MD, psychiatrist at New York-Presbyterian Hospital, Weill Cornell Medicine. “But actually, when we look back at their history, they already were having symptoms even as a child.”
Surprisingly, an estimated 31.9 percent of kids aged 13 to 18 have some type of anxiety disorder, according to the National Institute of Mental Health. (Here are the main types of anxiety disorders to know about.) But anxiety can set in before hitting your teenage years. “As many as one out of four to five children will have an anxiety disorder at one point,” says Dr. Saltz.
It may be hard for young children to convey anxious or stressed feelings the way we adults might, but you can pick up on clues from their behaviors that they may be suffering from anxiety. Here are key symptoms of anxiety disorders in children to look for, according to Khadijah Watkins, MD, psychiatrist at New York-Presbyterian Hospital, Weill Cornell Medicine.
Bellyaches and headaches. Learn other physical ways anxiety can affect the body here.
Resisting going to school. Almost all kids will drag their feet about going to school some days, but a child with anxiety disorder may be tearful or irritable in the mornings as you try to rush them through breakfast.
Frequent worrying. It might seem like your child has an “easy” life compared to yours, yet you may notice your child worrying relentlessly about grades, friendships, or performances in sports, according to the Anxiety and Depression Association of America (ADAA).
Constant need for reassurance and approval. Your child may regularly ask if everything’s going to be OK, if you think they did a good job, or if they’re “doing it right.”
Extreme shyness. Although being shy is not the same as having an anxiety disorder, some kids with anxiety may present as shy, nervous, and quiet around others—especially if they are dealing with social anxiety disorder .
Not playing with other children. Kids who feel anxious about what others think of them, or who are preoccupied with other worries, may distance themselves from their classmates and peers.
Trouble sleeping. “Kids worry about the next day. They worry about tests of social engagements that might be coming up,” says Dr. Watkins. Even the thought of deciding what to wear the next day may stress them out and keep them awake. (Here are other signs your kid is sleep deprived.)
Separation Anxiety Disorder in Children
Separation anxiety disorder is a particular concern for young children. It’s pretty normal for toddlers, but it can signal a problem if it extends beyond age 4. Separation anxiety disorder affects 4 percent of children and is most commonly diagnosed between ages seven and nine, according to ADAA.
If a child has separation anxiety disorder, “there is extreme fear around separating from one’s caregiver,” says Dr. Watkins. “It’s fear about something bad happening to themselves when they’re not with their caregivers, or something bad happening to [their caregivers].”
Children with separation anxiety disorder will have difficulty going to sleepaway camps, sleepovers, or school. They may seem “clingy” and want you to stay with them at bedtime. They may express homesickness when they’re away from you.
The Importance of Treating Anxiety in Children
Even if your child is showing symptoms of anxiety but they’re “not that bad” or “not causing problems,” it’s a good idea to seek help. “People tend to suffer in silence,” says Dr. Watkins. “The symptoms will grow and progress over time.” Contrary to popular belief, it doesn’t just go away on its own. (Learn other myths about anxiety disorders here.)
Many patients with anxiety do not get treatment until they’re adults, when the symptoms have become more impairing. Unfortunately, the longer you live with anxiety, the more difficult it can be to treat since the thought cycles become so cemented in your brain.
If your child’s anxiety is holding them back now, treatment could significantly improve their life path. “We think about failure to thrive and failure to launch, in terms of kids and adolescents going from high school to college to being productive members of society in the workforce,” says Dr. Watkins, “and how big an impact anxiety has played in being a barrier to that.”
Any anxiety disorder. Bethesda, MD: National Institute of Mental Health. (Accessed on January 8, 2021 at https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder.shtml.)
Childhood anxiety disorders. Silver Spring, MD: Anxiety and Depression Association of America. (Accessed on January 8, 2021 at https://adaa.org/living-with-anxiety/children/childhood-anxiety-disorders.)
Pharmacotherapy for anxiety disorders in children and adolescents. Waltham, MA: UpToDate, 2020. (Accessed on January 8, 2021 at https://www.uptodate.com/contents/pharmacotherapy-for-anxiety-disorders-in-children-and-adolescents.)