Stress Management Anxiety Symptoms in Children By Vincent Iannelli, MD facebook Vincent Iannelli, MD, is a board-certified pediatrician and fellow of the American Academy of Pediatrics. Dr. Iannelli has cared for children for more than 20 years. Learn about our editorial process Vincent Iannelli, MD Medically reviewed by Medically reviewed by Akeem Marsh, MD on December 13, 2020 twitter linkedin Akeem Marsh, MD, is a board-certified child, adolescent, and adult psychiatrist who has dedicated his career to working with medically underserved communities. Learn about our Review Board Akeem Marsh, MD on December 13, 2020 Print Brendan O'Sullivan / Getty Images New situations, challenging tasks, and even unfamiliar people can lead to fear and anxiety in children from time to time. Other age-appropriate fears include: Stranger anxiety beginning at 7 to 9 months of ageFear of the dark, monsters, insects, and animals in preschoolersFear of heights or storms in younger school-age childrenWorry 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. Childhood Anxiety Symptoms As much as it is common to have occasional anxiety, it is also common for children to have anxiety disorders. Children with true anxiety symptoms have them on most days and they can include: RestlessnessFatigueTrouble concentratingIrritabilityMuscle tensionTrouble 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 generalized anxiety disorder may also have somatic symptoms, such as headaches, abdominal pain, and muscle aches and pains. Fears and Phobias in Children 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. Other Anxiety Disorder Symptoms in Children 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 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 rateSweatingShakingFeeling short of breathFeeling chokedChest painNausea or abdominal painDizzinessNumbness or tingling (paresthesias)Chills or hot flashesFear of losing controlA 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. Persistent Anxiety Symptoms Your pediatrician, a child psychologist, and/or a child psychiatrist can be helpful if your child has persistent anxiety symptoms. The 7 Best Online Therapy Programs for Kids Was this page helpful? Thanks for your feedback! Struggling with stress? Our guide offers expert advice on how to better manage stress levels. Get it FREE when you sign up for our newsletter. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Freidl EK, Stroeh OM, Elkins RM, Steinberg E, Albano AM, Rynn M. Assessment and treatment of anxiety among children and adolescents. Focus (Am Psychiatr Publ). 2017;15(2):144-156. doi:10.1176/appi.focus.20160047 Gale CK, Millichamp J. Generalised anxiety disorder in children and adolescents. BMJ Clin Evid. 2016;2016. Krebs G, Heyman I. Obsessive-compulsive disorder in children and adolescents. Arch Dis Child. 2015;100(5):495-9. doi: 10.1136/archdischild-2014-306934 Anxiety Disorders Association of America. Anxiety disorders in children. Driessen J, Blom JD, Muris P, Blashfield RK, Molendijk ML. Anxiety in children with selective mutism: a meta-analysis. Child Psychiatry Hum Dev. 2019. doi:10.1007/s10578-019-00933-1 Additional Reading Kliegman: Nelson Textbook of Pediatrics, 18th ed.