Anxiety: Recognizing and reducing symptoms in children

“ANXIETY” IS AN INCREASINGLY POPULAR CONCERN IN CONVERSATION IN THE DEVELOPED WORLD. Only one word in English serves for both the normal sense of anxiety and the psychiatric sense. In spite of growing attempts, the true definition, causes, types, expressions and treatments of anxiety disorders remains blurred.  


The explosion in recent findings regarding anxiety causes and treatment delays, points to a clear need for earlier recognition. The results of a recent study published by the National Institutes of Health reports that the average amount of time between onset of mental illness and seeking treatment is 10 years. Why is there such a delay? Delay in seeking treatment is complex. Depending on many structures of our society, simply identifying anxiety in younger populations, has the potential to make a great difference.  

 Recognizing anxiety in children has been publicized for years as being especially important for both prevention of maladaptive responses and healthy development. I’ve seen evidence of this myself, working with youth directly, and reviewing research as an assistant in the educational psychology department at the University of Minnesota, Twin Cities. 

Unrecognized, unregulated stress in children can have detrimental effects on child well-being and academic performance. Additionally, improved ability to regulate stress has been shown to be critical to even enhancing child well-being. Certainly, a collective hope for children, who today are increasingly exposed to an anxiety-inducing world, is the fostered confidence that overcoming anxiety is possible and beneficial.


Kristine M. Meyer, MA, LP, a therapy provider with special interest in anxiety disorders with Associates in Psychiatry & Psychology of Rochester, comments, “Anxiety (in children) can be normal and even appropriate at times,” but warns, “when anxiety or fears become excessive or persistent, they can last for months or years if left untreated.” Recognizing anxiety in children starts with being familiar with normal for the specific child, then applying knowledge of the different causes and types of anxiety disorders; anxiety in children often manifests through differing symptoms, and even different types of anxiety than the child’s parents and adult relatives.

With anxiety, the extent of impact from genetics and environment are highly individualized, and generalizing the cause of anxiety is nearly impossible. Nevertheless, genetic proneness is credible and should not be ignored. A study on the heredity of anxiety done by Everyday Health found when anxiety develops before age 20, other relatives are more likely to have anxiety in some form. The key is, while relatives have proneness in common, anxiety can take on different forms throughout development and experiences. Therefore, recognizing anxiety in children involves being mindful of unfamiliar or unpredicted forms of anxiety. 


From Meyer’s experience, “One of the more common types (of anxiety in children) is separation anxiety, which involves excessive fear of separating from their caregivers.” Separation anxiety often stems from a fear that something bad will happen to their caregiver and can lead to physical symptoms such as headaches, stomachaches and vomiting. 

Meyer also describes specific phobias and selective mutism as common forms of anxiety she has seen in children. Specific phobias, common in childhood, can result in absolute avoidance and panic around the feared object or situation. Selective mutism, although less common, typically occurs in early childhood. It can be quite debilitating for children to be left uncontrollably mute in social situations, despite being able to speak freely in more comfortable environments, like home. Other anxiety disorders, Meyer notes, that can occur in childhood include social anxiety disorder, panic disorder and generalized anxiety disorder (GAD).

Like depression, anxiety can be first recognized by a child’s increased seclusion or desire for alone time. Decreasing social interaction, and not facing fears, propels a downward spiral of a child being less willing to participate in fear experiences in the future. Conversely, a child with GAD, for example, will worry excessively about a variety of things in life such as grades, family issues, relationships with peers and performance in activities. Tending to be hard on themselves, and perfectionists, they can constantly seek approval and reassurance from others rather than seclude themselves. These classic deviances from normal are a crucial time to consult a professional. What most sets children apart from adults, is a child’s difficulty understanding that their anxiety is irrational.  


A wide range in genetics and backgrounds necessitates adaptable and innovative treatment options. Psychotherapy, medications, complementary health approaches or most effectively, a combination of approaches, have all been shown to decrease symptoms. 

As mentioned previously, an individual’s ability to cope depends on a variety of factors that can also affect their treatment plan. Key factors, Meyer mentions, are the essentials of self-care which include adequate nutrition, sleep and emotional support. Improving self-care will also improve the efficacy of other treatments methods. While it’s natural to be cautious about medication use in children, Meyer attests that with the help of medication to calm physical symptoms, children can much better manage their fearful thoughts and symptoms in psychotherapy. 

Cognitive behavioral therapy (CBT) is a form of psychotherapy that has been shown to be the most effective management of anxiety. When adhered to, CBT works by improving coping and motivation for wellness. Meyer provides therapy to children from a cognitive-behavioral perspective herself. She affirms, “Treatment often includes a combination of learning relaxation skills, challenging the thoughts that trigger their fears and controlled, gradual exposures to their fears.” 

I have done extensive research myself on the effectiveness and acceptance of virtual reality and mindfulness imagery for stress reduction. Finding an approach that is likable by children is half the battle of effective treatment and currently at the forefront of research. 


Not only are people with an anxiety disorder affected, but everyone in the lives of those with an anxiety disorder are indirectly affected. Considering the statistic that about one in five adults over the age of 18 have an anxiety disorder—it’s rare to not have a connection to someone with an anxiety disorder. 

In the world of pediatric healthcare, this startling adult statistic, raises concerns about youth mental health, growing up in a world with more anxiety-affected adults than ever before. In efforts to reduce the mental health stigma, adults are beginning to talk about anxiety with other adults. However, child anxiety and recognizing symptoms in a child are much less often topics of conversation and deserve more attention.


Straightening out the main proponents of anxiety is a huge step to a greater understanding of the anxiety crisis. Managing mental health does not have set protocols, therefore recognition and treatment of anxiety for example, will continue to change, as does human society and environment. By reducing the overall mental health stigma, people can get the treatment they need much faster. 

Many people shy away from conversing at length about mental health. However, serious matters, when spoken on thoughtfully, don’t have to be uncomfortable. They can be enriching and empowering. Let this article be a conversation starter.

*DISCLAIMER This article is meant to bring together gathered information on anxiety, from information available on public websites (Mayo Clinic, NAMI, Neuro Core Centers, Anxiety Panic Health, and Anxiety and Depression Association of America) and from community members. It is in no way meant to be a device of diagnosis. Should you have concerns about the mental health of yourself, your child, or someone else in your life, please consult a medical professional right away. 

Tiffany L. Hansen graduated from the University of Minnesota CLA 2018 with a Bachelor of Science in Psychology and Bachelor of Arts in Biology, Society and Environment with Latin and Neuroscience minors.