Childhood Anxiety

Anxiety and worry are a normal part of childhood development. It is the body’s way of preparing for unfamiliar and potentially dangerous experiences. As children grow, they are often faced with new situations and experiences that can cause feelings of fear and anxiousness. For younger children, normal worries could include meeting new people or starting school, while for older children and teens, this could be sitting an exam at school, speaking in public or entering a sports race. In these situations, anxiety can help children be more alert and focused.

However, in some cases, anxiety can be difficult to control and interferes with a child’s ability to participate in daily tasks. If your child is experiencing anxiety more significantly than others their age, they may need additional support or be showing signs of an anxiety disorder.

What is Childhood Anxiety?

Anxiety is a common mental health condition affecting many children, including 1 in 7 young Australians. It is characterised by intense fear, worry or dread that is disproportionate to the situation and hinders a person’s ability to function and participate fully in everyday life.

Types of Anxiety Common in Children

Anxiety disorders may be diagnosed when a child’s anxious feelings are more excessive, persistent, or irrational than what is considered normal for their age and situation. They often present with persistent psychological, physical, and behavioural changes that interfere with their ability to perform daily tasks.

Some of the most common childhood anxiety disorders include:

Signs of Anxiety in Children

There are several signs and symptoms of anxiety in children. These may vary depending on the type of anxiety they are experiencing and not all are obvious.

Anxious children may experience a combination of psychological, physical and behavioural symptoms.

Signs of anxiety may include:

• rapid heart rate and breathing
• restlessness and irritability
• difficulty concentrating
• mind going blank
• persistent worry
• angry outbursts, tantrums or meltdowns
• difficulty sleeping or disrupted sleep due to nightmares or night terrors
• changes in appetite
• shaking and dizziness
• unexplained stomach pain, vomiting, headaches or muscle pains
• avoidance of places and activities

These symptoms are not exclusive to anxiety and most children will experience them at different times. If these signs appear frequently, in a consistent pattern and impact daily life, they may indicate your child is anxious.

What Causes Anxiety in Children

There is no one cause for anxiety. Some children are naturally more likely to have worries and anxiety while others may develop anxiety following a distressing experience.

• Genetic factors: Children with a family history of anxiety are more likely to develop anxiety than children without a family history.
• Developmental factors: There is a strong co-occurence of anxiety in children with ADHD, Autism and other neurodevelopmental disorders.
• Distressing life events: Events such as illness, death of a loved one, violence, or a car accident can cause severe stress that changes the way a child responds to experiences in their life.
• Learned behaviour: Children who are frequently exposed to others who are worried or anxious are more likely to develop anxious feelings and behaviors themselves.

How is Anxiety Diagnosed in Children

There is no one test that can determine whether a child has anxiety. If your child is showing signs of anxiety, an important first step is visiting a GP or paediatrician to rule out any other medical conditions.

A mental health professional such as a GP, psychologist or psychiatrist can diagnose different anxiety disorders using criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM). A comprehensive assessment usually involves a questionnaire that asks about different aspects of the child’s life, including:

• Home and environment
• Education and school experience
• Extra curricular activities
• Relationships
• Conduct and risk-taking activities
• Eating, sleep and other lifestyle factors
• Self-harm and suicide risk
• Psychosis and mania symptoms

Mental health professionals may use a range of standardised assessment tools alongside the questionnaire to understand your child’s overall wellbeing.

How Families Can Help Their Child

Whether your child has a diagnosis or not, there are lots of simple ways to support them with their anxiety and worries. Some strategies can be used to calm down in an anxious moment while others can be used in a calm, safe space to build resilience and coping skills to minimise the impact of anxiety on everyday life.

Some important strategies to consider include:

• Keep a consistent routine: Ensure you are eating meals, sleeping and exercising around the same time each day to give them the best opportunity to manage their emotions and behaviours.
• Validate their feelings: Label what you see in your child and reassure them that others feel these things too. For example, “You seem worried about having a different teacher today. I know other children might feel nervous to meet new people too.”
• Use Co-Regulation Strategies: Support your child to calm their anxious thoughts or feelings by holding their hand, hugging them or just sitting quietly near them.
• Schedule relaxing activities: Find what makes your child feel calm such as listening to music or drawing and make this part of your daily routine.
• Practice mindfulness: take deep breaths, try yoga, write a journal or listen to a guided meditation
• Role Play Scenarios: Use toys to act out different situations that may make children feel anxious and strategies they can use in each.
• Talk to your child’s teacher: Exchange strategies and ensure your child has the support they need to cope at school.
• Talk about support services: Ensure your child knows where and how to seek professional support when they need it
• Offer encouragement: Gently encourage your child to do the things that make them anxious by taking smaller steps and praising them when they try.

Financial Assistance for Children with Anxiety

Children with anxiety may be eligible to receive Medicare rebates for up to 10 sessions with a mental health professional through the Better Access to Mental Health Care initiative.

A mental health care plan from your GP or referral from a psychiatrist or paediatrician is required if seeking to claim Medicare rebates through the Better Access to Mental Health Care program.