– A Parent’s Guide –

Here’s a parent’s guide to childhood anxiety.

So if you want to start the journey to better understanding your child’s anxiety (or even if they might be anxious), you’ll enjoy this overview.

Let’s jump in!




Generalized Anxiety Disorder (GAD)

Children who have generalized anxiety disorder, or GAD, feel a high amount of worry, nervousness, and fear.

This typically shows up as physical, emotional, and behavioral symptoms.

Their anxiety is focused on a number of different things and is severe enough to significantly hurt their ability to thrive in relationships, school work, or other activities.

Signs of Generalized Anxiety Disorder

Physical Signs

Your child may have:

  • muscle tension,
  • headaches,
  • dizziness,
  • nausea,
  • diarrhea or stomach aches,
  • be restless or easily startled,
  • become tired easily
  • have trouble relaxing and sleeping.
Emotional Signs

Your child may be worried about:

  • their grades in school,
  • being judged in social contexts,
  • getting sick or hurt,
  • losing a loved one, or
  • be a perfectionist.

For these children, the worries they have are not proportionate to reality and they feel out of control of their worries.

Behavioral Signs

He or she may avoid age appropriate activities, not be able to concentrate on tasks, or become easily frustrated or oppositional as a result of their worries.  



Panic Disorder in Children

A panic attack is a sudden feeling of fear and anxiety that is very intense that takes several minutes to subside.

Attacks could occur at various rates such as one time per week for several months or every day for a couple of weeks followed by none for many weeks.

Children with panic disorder experience recurrent panic attacks that happen unexpectedly and are worried they will have more panic attacks or change their behavior related to the attacks such as attempting to avoid them.

An attack could start when a person is anxious or when they are calm, when awake or asleep.

Signs of Panic Disorder / Attacks

Physical Signs
  • Heart rate increasing.
  • Trembling or numbness.
  • Shallow breaths or feelings of choking.
  • Feeling nauseous or dizzy.
  • Feeling hot and cold alternately.
  • Feeling detached from yourself.
  • Feeling like you will die.
Common Worries

Worries people have about anticipating a panic attack include peers mistaking symptoms for other life-threatening emergencies, embarrassment about showing symptoms in public, and fear that they are “crazy” or out of control.


More on Panic Disorder

According to the CDC via National Institute of Mental Health (NIMH), 0.4% of children ages 8-15 will have a diagnosis of a panic disorder in any given 12-month period. (SOURCE)

According to the DSM-5, Native Americans have the highest prevalence rates of panic disorder followed by non-Hispanic whites and Hispanics, African Americans, Caribbean blacks, and Asian Americans report much lower rates of panic disorder (2013, p. 210). Although the median age of symptom onset is 20-24 years, some cases do begin in childhood (p. 210). Despite the uncommon diagnosis in childhood, many who have this disorder as adults recall “fear spells” during their childhood years (p. 210).



Separation Anxiety Disorder in Children

Separation anxiety disorder is diagnosed when a child has anxiety about leaving a primary caregiver that is beyond what is developmentally expected at the child’s age.

With these children, excessive fear and symptoms related to separation from a caregiver last more than four weeks.

This condition often starts after a major life event that is stressful for the child such as a death in the family or a move to a new place.

Signs of Separation Anxiety Disorder

Physical & Emotional Signs
  • Excessive anxiety and physical symptoms (like headaches and stomach aches or vomiting) when thinking about or actually going through separation.
  • Worrying about an event causing separation such as getting lost or a caregiver dying.
  • Fear of being alone or leaving the house, refusing to sleep away from caregivers, and having nightmares about separation.
  • These symptoms must be severe enough that the child’s relationships, school work, or other daily activities are significantly impacted.
Behavioral Signs

This may show in your child as withdrawal, anger or aggression toward the person causing separation, or a “demanding” personality in need of a lot of extra support and attention.

According to the DSM-5, approximately 4% of children in the US have separation anxiety disorder symptoms within a 12 month period, and it is the most common anxiety disorder for children 12 years and younger (2013, p. 192).  



Social Anxiety Disorder in Children

If a child’s worry is focused on social situations where they may feel evaluated by others, they have social anxiety disorder.

They may be afraid of meeting new people or performing in front of others and the symptoms last for six months or more.

For these children, they have fears about interacting with peers their age, not just with adults.

Children with these symptoms believe their fears are real threats, but in reality, the fears are not proportionate with the situation at hand.

Signs of Social Anxiety Disorder

Physical & Emotional Signs
  • Your child may become fearful while thinking about or being in social situations,
  • Avoiding social situations,
  • Fear of doing something socially inappropriate that will make others judge them.
Behavioral Signs

The fear and anxiety may show up behaviorally in:

  • Tantrums, crying.
  • Freezing up and not being able to talk.
  • Clinging to someone.
  • Or shrinking to the floor or chair.

Their symptoms are severe enough that they cause great impact on their relationships, school work, or other daily activities.

The prevalence of social anxiety disorder in children in the US is about the same as in adults according to the DSM-5–about 7% of people (children, adolescents, and adults) experience symptoms in a 12 month period (2013, p. 204).



Sports Performance Anxiety in Children

When your child athlete is participating in their sport, they need adrenaline. Adrenaline feels like pre-game jitters and nervousness. This is normal.

However, for some athletes, their pre-game jitters make them feel extra jittery and weak, or their nervousness turns into nausea, interfering with their performance.

Signs of Sports Performance Anxiety

Physical & Emotional Signs

Developing symptoms stemming from anxiety:

  • Stomach pains
  • Headaches
  • Feeling dizzy
  • Irritability and trouble sleeping
  • Pretending they are sick or injured to avoid participating, going to practices, or games
Behavioral Signs

Changes in thinking or unusual behavior, such as:

  • Negative self-talk

  • Hesitation

  • Decreased confidence during sport


If you would like help navigating your child’s anxiety, please give us a call. We specialize in helping anxious children.

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