Anxiety is the most common mental health condition, with about a third of all people meeting the criteria for an anxiety disorder at some point in their lifetime, says Dr. Amy Lee, a pediatric psychologist at Cleveland Clinic Children’s.
Lee, who has been with the Clinic for 31 years, has seen anxiety in children rise notably in that time, and significantly so since the start of the pandemic.
There are a lot of factors at play: more isolation, more social media, more structured activities. A stronger focus on achievement. Less time for independence-building free play.
But anxiety is not always a problem parents need to be concerned about.
“Many times, anxiety is a sign of positive brain development, cognitive development,” Lee says.
For example, Lee says, stranger anxiety is common in babies, and that’s actually a good thing: it’s a “protective” anxiety that demonstrates that they recognize their caregivers and can differentiate them from others. Fears and phobias in preschool or elementary school-age children can be a sign that their imagination and their ability to anticipate potential outcomes are developing.
Parents can help children manage these developmentally normal types of fears by controlling their exposure to them, Lee says, and help them face those fears with support. They can also help children learn how to calm the feelings of anxiety or stress in their bodies with skills like deep breathing, or teach them how to counteract fears and what ifs with positive truths.
Dr. Elle Brennan, who works in the division of Behavioral Health at Akron Children’s Hospital, says, often, parents can help simply by talking to their children about what they’re finding challenging and helping them find solutions, like practicing a skill that’s worrying them or managing expectations around something.
One behavior parents should watch for in their children is avoidance, Brennan says. That might look like clinginess or fussiness in a young child, a loss in confidence in an early adolescent or irritableness or procrastination in an older teen.
Anxiety rises from the level of an emotion to a disorder when there’s a “consistent pattern,” Brennan says, and when anxiety and avoidance affect how a child functions.
And Lee noted that some children may show physical signs of stress or anxiety, like headaches or stomach aches, without being aware of those underlying feelings.
When fear begins to impair the rest of a child’s life — holding them back from trying new activities or making friends, keeping them from school or sleep — outside help might be needed. A good place to start is a child’s pediatrician, Lee says, but schools can also offer valuable support.
A lot of kids (and adults) today worry about the big issues in their world, Lee notes, such as war, the climate, germs.
“But a sign of good psychological health is the ability to be able to flexibly attend to that,” Lee says.
Someone who has an anxiety disorder may have more trouble flipping from a large-scale worry to their current reality, where they may be safe and away from immediate harm. They may get overwhelmed or find ways to avoid those thoughts and feelings.
If therapy is necessary, Brennan says there are a variety of treatment options. Supportive counseling that helps children gain skills to handle anxiety, like belly breathing, is usually a first step, but may not be enough, she says. The “gold standard” is exposure therapy, where a professional will help the patient actively face their fears.
It can be a tough process, Brennan says, but she hopes families know it’s an option.
