Anxiety is the experience of fear, distress, or worry. It often happens in response to a stressful situation. But it can also occur without a specific trigger. Anxiety might involve worry about something that happened in the past or about something bad happening in the future.
In most cases, children and teens cope well. Less often, anxiety causes ongoing problems. This may suggest an anxiety disorder.
Resources and services are available to help people with anxiety and anxiety disorders.
Anxiety during serious illness
Anxiety is common for any person facing a serious illness. Parents, family caregivers, and siblings may also struggle with worry and anxiety.
Each person experiences anxiety differently. Younger children may have trouble naming and talking about feelings of anxiety. Older children and teens may not want to discuss their worries because they do not want to upset people close to them or make things more stressful. It can be hard to talk about emotions. But open communication with each other and with your care team is important to make sure you have the resources you need.
The worry about tests and waiting for imaging test or scan results has an unofficial name — “scanxiety.” Scan anxiety, or scanxiety, is stress about imaging tests used to find cancer or other problems. In a broader sense, the term means the worry that occurs before, during, and after any medical exam or test.
Signs and symptoms of anxiety in children and teens may include:
Feeling stressed, worried, or scared
Getting upset easily
Trouble thinking or concentrating
Restlessness, not being able to settle down
Crying more than usual
Not wanting to be left alone, clinging to loved ones
Avoiding activities or situations that cause anxiety
Increased need for reassurance
Increased heart rate or fast breathing
Change in eating habits
Upset stomach, stomach pain, constipation, or diarrhea
Nervous habits such as nail biting or picking at skin
Many symptoms can occur due to physical illness or as a side effect of living with a difficult medical diagnosis. A mental health provider can help you understand anxiety symptoms and how best to manage them.
Anxiety disorders in children and teens
An anxiety disorder is ongoing fear or worry that negatively affects a person’s daily life or causes extreme distress.
Usually, anxiety is part of a normal range of thoughts and emotions. But symptoms of anxiety that negatively impact daily life or do not improve may also signal an anxiety disorder or other mental illness that needs treatment.
Types of anxiety disorders
Anxiety disorders are diagnosed based on symptoms. Anxiety disorders include:
Separation anxiety disorder
In separation anxiety disorder, a person has intense anxiety about being separated from another person. For children, this is often the fear of being away from one or both parents. The child may worry that something bad will happen if their parent leaves. Other symptoms of separation anxiety disorder may include clinging behavior, nightmares, trouble sleeping by themselves, and avoiding being alone.
A person with a specific phobia has an intense fear of a certain object or situation that is much more than what someone might expect. This often leads the person to worry about the phobia and take steps to avoid that object or event.
In social anxiety disorder, a person has extreme fear or anxiety about social situations or performing in front of others. They worry about what others will think of them and may avoid certain settings. This can often lead to problems in school or work, and with friendships. A child with social anxiety disorder may appear shy or withdrawn.
In panic disorder, a person has repeated, sudden panic attacks. The attacks usually last only a few minutes. They may be unexpected or triggered by a feared object or event. During a panic attack, a person may have:
In obsessive-compulsive disorder, a person has repeated thoughts (obsessions) that are unwanted and lead to anxiety. The person may have an intense need to do certain things (compulsions) to relieve distress. These may become rituals.
Examples of rituals or compulsive behaviors include:
OCD usually develops in teens or young adults but may also occur in children. It may occur in families. The person often knows that their thoughts and behaviors are not rational but is not able to control them.
Main treatments for anxiety disorders include cognitive behavioral therapy (CBT) and medicines.
Cognitive behavioral therapy (CBT)
CBT is a type of therapy that helps a person understand the relationship between thoughts, feelings, and behaviors. A CBT practitioner provides strategies to change thoughts and behaviors to improve well-being.
Your child can learn ways to lessen the effect of stress and anxiety with relaxation techniques. These techniques can include deep breathing, guided imagery, and muscle relaxation. CBT is often the first recommendation for treating anxiety disorders in children and adolescents.
Anxiety medicines for children and teens
A health care provider may prescribe medicine to help with anxiety symptoms. Some patients may need medicine that works over time to treat an anxiety disorder. Some patients may need a combination of medicines.
Patients taking medicines for anxiety need to visit their health care provider regularly to make sure the medicines work properly. The health care team will also monitor any side effects. Always follow medication instructions from your health care provider. Do not take more medicine than prescribed. Do not stop taking the medicine without talking to the care team first.
Talk to your child’s care team before making any dose changes. Also, be sure to store medicines safely. Keep them out of the reach of children.
Tell your health care provider if your child’s anxiety symptoms do not improve or if they get worse.
Coping with anxiety during illness
Managing anxiety is important. There are a variety of strategies that may help. Talk with your care team to make a plan that works best for your child and their specific situation.
Talk openly: It can be hard to talk with children about fears and worries. It might also be difficult for children to share their worries with adults.
Look for ways to talk about thoughts and feelings on a regular basis. This makes it easier to have hard conversations when they arise.
Use a variety of feeling words (such as mad, happy, scared, or nervous) to help children process emotions and talk about anxiety.
Ask instead of assuming. Use open-ended questions to understand your child’s point of view.
Recognize and respect your child’s concerns, even when you don’t agree.
Admit that you sometimes have similar anxious thoughts and feelings. This helps your child know that they are not alone.
Keep a journal to track thoughts and feelings.
Use coping skills and resources to help manage anxiety: Make it a habit to use coping skills even when things are going well. This will make the strategies easier to use when they are needed. Having more than 1 method to deal with anxiety is also important. Sometimes a usual coping strategy cannot be used or does not help.
Distraction techniques: Engaging in activities they enjoy can distract children from anxiety-causing thoughts. These may include art therapy, music therapy, and play therapy.
Mindfulness and relaxation strategies: Your child can learn ways to lessen the effect of stress and anxiety. Examples of relaxation techniques include deep breathing, guided imagery, and muscle relaxation.
Mind and body practices: Some children find help from mind and body practices such as biofeedback, massage therapy, yoga, and physical exercise. Research shows that these therapies can change nerve signals and chemical messages in the brain to help improve anxiety.
Reach out to friends and family: Social support is important for patients and families facing serious illnesses. Help children and teens stay connected to friends and do usual activities that they enjoy.
Consider support groups: Patients and families often find that it is easier to share their experience with someone who has been there. Joining a support group, taking part in group activities, or making new friends in the hospital can give patients a safe place to talk about anxiety and find ways to cope. Join the Together Community
Manage your own anxiety and stress: Stay calm when your child is anxious. Children sense the moods of those close to them. They also learn coping strategies from watching others. Parents and caregivers need to take care of their own mental health. Find ways to manage your own anxiety so that your child can know they can do it too.
Encourage your child to face their fears: Children and teens with anxiety often avoid situations they fear. At first, this may decrease their anxiety. But over time avoidance helps maintain or even worsen anxiety. Praise your child for getting through a hard situation.
Offer security without being overprotective: Parents want to protect their children from both physical and emotional hurt. Offer your child age-appropriate ways to be independent. This helps children develop confidence in their own abilities to solve problems.
Seek help for your child or yourself if anxiety symptoms get worse: Medical needs are often the most important concern when a child is seriously ill. But anxiety can have a negative impact on physical health and medical outcomes. Asking for help is not a sign of weakness. Talk to your care team or mental health provider.
Questions to ask your care team about anxiety
What signs or symptoms of anxiety should I look for in my child?
What are some ways I can help my child deal with anxiety?
When should we see a mental health professional?
What treatments for anxiety do you recommend?
What coping skills can we use for anxiety?
Key points about anxiety
It is normal for children and teens to feel anxiety in response to a stressful situation.
If your child’s anxiety gets worse, interferes with daily activities or relationships, or continues after the stressful event is over, they may have an anxiety disorder that needs treatment.
Treatment for anxiety disorders can include therapies and medicines.
Other ways to help your child cope with anxiety include having open communication, seeking social support, taking care of your own mental health, and developing and using coping skills.