What is it?

Anxiety is a general term used to describe a feeling of extreme worry or unease. When a child feels anxiety that lasts a long time and prevents them from doing things like going to school or playing with their friends, then it becomes an anxiety disorder.

Anxiety is normal and a part of life. When a child is threatened or in actual danger, their body has an alarm system that prepares the body to defend them from harm. Symptoms of anxiety are accompanied by a “fight, flight or freeze” reaction, which is triggered by real or imagined threats.

What types of anxiety are common in children?

Generalized anxiety disorder: Children with generalized anxiety disorder tend to have worries that span multiple topics. It causes children to worry almost every day — and over lots of things.

Panic disorder: Children with panic disorder have frequent, sudden anxiety attacks that can cause overwhelming physical symptoms.

Separation anxiety: Children who experience separation anxiety get very anxious and upset when separated from parents and caregivers. They worry that bad things will happen to them or loved ones while separated.

Social anxiety: Children with social anxiety have an intense fear of social situations and become self-conscious around others.

Specific phobia: While it’s normal for children to have fears, some children can experience a more intense and longer-lasting irrational fear of certain things (e.g. fear of enclosed spaces, insects, needles, thunder).

What are the symptoms of anxiety disorders?

Anxiety has many symptoms and can look different from child to child.

Physical symptoms include:

• Crying
• Rapid heart rate
• Quick breathing or difficulty catching one’s breath
• Muscle aches (especially stomach and headaches)
• Quick irritability and being out of control during outbursts
• Feeling tense and fidgety
• Using the toilet often
• Shaking, dizziness, tingling
• Sweating
• Fatigue

Emotional symptoms include:

• Ongoing worries about friends, school, or activities
• Worrying about things before they happen
• A need for everything to be “perfect”
• Constant thoughts and fears about their safety (or of others, such as parents and siblings)
• Reluctance or refusal to go to school
• “Clingy” behaviour
• Inability to concentrate
• Irritability
• Trouble sleeping
• Inability to relax

When is it time to seek professional help?

1. When it is not getting better or is getting worse, and efforts to tackle it yourself have not worked

2. When it’s slowing down their development or having a significant effect on their schooling or relationships

3. When it happens very frequently

What can be done?

A severe anxiety disorder can delay or derail child development. Research shows that there are two main treatments that often help children or youth with an anxiety disorder.
1. Cognitive Behavioural Therapy (CBT) is an evidence-based and structured type of therapy that focuses on teaching children and families how to:

• identify and challenge anxious thoughts
• practice facing feared situations in a stepwise way
• helping parents and caregivers to promote courageousness in children and change patterns of reassurance

2. Medications are sometimes a useful component of treating children with anxiety.

What makes some children more vulnerable to anxiety?

• Biological factors such as genes and brain chemistry
• Psychological factors such as temperament and coping strategies
• Environmental factors such as anxious parenting, trauma, adverse childhood experiences and toxic stress

Where can I access support?

Talk to the child’s family doctor or pediatrician if anxiety causes the child to limit participation in activities or worry often.

Talk to the child’s guardianship worker to explore what options are available for assessment so their diagnosis and treatment plan can be included in their Care Plan. The guardianship worker will help make appropriate referrals for specialized supports and services.

Get help from a mental health professional by getting an assessment through your local Child and Youth Mental Health team. Your local CYMH office offers a range of free and voluntary mental health services and supports for children from 0-18 years of age and their families. These services include assessments, therapy and treatment, education and referrals to specialized programs and resources. There are 100 intake clinics for children, youth and their families at convenient locations throughout BC.

You can also contact a private psychologist or counsellor through the BC Association of Clinical Counsellors or the BC Psychological Association. You can use website filters to search for a counsellor in your community that specializes in certain mental health challenges.