Anxiety Symptoms in Children

It is usually expected that all children will experience some fear or anxiety from time to time.

New situations, challenging tasks, and even unfamiliar people can all lead to some anxiety in most children.

Other age-appropriate fears include:

• stranger anxiety beginning at 7 to 9 months of age
• fear of the dark, monsters, insects, and animals in preschoolers
• fear of heights or storms in younger school-age children
• worry about school and friends in older school-age children and teens

It takes a little more than occasional anxiety, which can be normal, to indicate true symptoms of an anxiety disorder, though.

As much as it is common to have occasional anxiety, it is also common for children to have anxiety disorders. In fact, anxiety disorders are more common than ADHD or childhood depression and are the most common psychiatric disorders in children.

Children with true anxiety symptoms have them on most days and they can include:

• restlessness
• fatigue
• trouble concentrating
• irritability
• muscle tension
• trouble sleeping (insomnia)

As part of a diagnosis of a generalized anxiety disorder (GAD), a child should have one of these symptoms for six months or more, and they should be triggered by more than one thing, such as being anxious about work, school, and friends.

Also, a child with a generalized anxiety disorder will have trouble controlling her feelings of worry and it will cause her distress and some kind of impairment. For example, she may be so irritable from not sleeping that she is having trouble keeping her friends or her grades are dropping because she can't concentrate.

Children with a generalized anxiety disorder may also have somatic symptoms, such as headaches, abdominal pain, and muscle aches and pains.

In addition to a generalized anxiety disorder, children can have more specific phobias.​

They become anxious and worried, but only after very specific triggers, such as a thunderstorm, spiders, being left alone, or going in a swimming pool, etc. Although these children may cry and may cling to their parents if they are around or think they will be around something they are really afraid of, fortunately, most kids outgrow this type of anxiety disorder.

Like adults, children can also have other anxiety disorders, which range from separation anxiety and obsessive-compulsive disorder (OCD) to panic attacks.

While symptoms of separation anxiety are typically easy to recognize, a child who refuses to go to school, sleep alone, or go anywhere without a parent, other anxiety disorders can be a little harder to detect.

Children with OCD, for example, may have either recurrent, time-consuming thoughts or impulses (obsessions) about certain things or repetitive behaviors or mental acts (compulsions) that they perform, such as washing their hands a lot, checking things over and over, or repeating certain words or phrases to themselves.

Although uncommon in children, panic attacks are another type of anxiety disorder that does become more common in later teen years. In addition to intense fear or discomfort, children having a panic attack should have four or more of the following symptoms:

• palpitations or a fast heart rate
• sweating
• shaking
• feeling short of breath
• feeling choked
• chest pain
• nausea or abdominal pain
• dizziness
• numbness or tingling (paresthesias)
• chills or hot flashes
• a fear of losing control
• a feeling of unreality (derealization) or being detached from oneself (depersonalization)

Of all of the anxiety disorders in children, selective mutism is perhaps the one that is most commonly overlooked, as people think these children are just extremely shy. Children with selective mutism actually refuse to talk though and may only talk to close family members at home. At school or in other situations, they often become anxious and very uncomfortable when they are expected to talk.

Your pediatrician, a child psychologist, and/or a child psychiatrist can be helpful if your child has persistent anxiety symptoms.