Recognizing and Treating Anxiety in Children



By Mary Ellen Christy



Anxiety is a healthy and useful human emotion. We can thank anxiety for our survival for thousands of years. Once upon a time when we were at risk of being eaten by larger and woolier creatures and needed to forage for or capture our own food and construct our own shelter, our wonderfully adaptive human brains created the anxiety response. This response creates a number of physical responses in our bodies altering us of possible danger and sending the message to flee, fight or freeze. For example, you are walking to your car in a darkened parking lot and suddenly you think you see a large shadow on your left and the hair stands up on the back of your neck. When you are taking your oral comprehensive exams before a committee who will determine whether or not an advanced degree is conferred upon you; the slight headache, the sweaty palms, and tightness in your chest are all part of the anxiety response.

When a child has been absent from school for several days because their best friend moved away, their teacher was on maternity leave, the substitute looks mean, and their show and tell has mysteriously disappeared from their backpack; it seems like the entire world has morphed into a strange and scary place. They try not to cry but feel sick to their stomach and begin to hyperventilate. Because children’s perceptions of the world are so different, their responses can be extreme.



The human brain is a complicated and marvelous organ. It is ever-changing constantly sending signals to other parts of our body, telling us to move, solve problems, speak and show emotion. Because we have a greater understanding of the brain, we can now better understand the origins of anxiety and what treatments are available. Signals of perceived danger are sent from the medulla, at the center of our brains to the frontal cortex alerting us to danger. Anxiety becomes problematic when the delicate balance of this process changes and the anxiety response is happening too frequently.

The rapid breathing associated with extreme anxiety known as hyperventilating can be eased through a number of breathing techniques: breathing into a paper bag, using the 4-7-8 breathing technique, (also known as relaxing breathing) or the 7-11 breathing technique. With children, the simple act of taking 3 big deep breaths brings more oxygen into their bodies and helps center them. A great deal of new research reveals that mindfulness leads to effective techniques in controlling anxiety in young children.

There is no question that contemporary life has changed in so many ways that can be anxiety-provoking. Everything seems much more complicated and intrusive and leisure time within the family has diminished. The intrusion of devices has had a deleterious effect on all of us but particularly on children. The increase in adults and children suffering from anxiety disorders is alarming. According to a Harvard study of anxiety, in 2003 the number of children ages 3-17 being treated for anxiety and depression was 5.4% By 2011, it had risen to 8.4% and today it stands at 25%. It is even worse for adults. The number of adults seeking treatment for anxiety and depression is 40%.



That may be the bad news but the very good news is that anxiety disorders are some of the most treatable of all mental health disorders. Because anxiety at any age is a medical problem, the most appropriate course of seeking a solution is with a competent and caring physician or in the case of children, a developmental pediatrician. Coupled with an appropriate intervention with the right expert, the rates of successful treatment are amazing.




Some symptoms to look for if you suspect your child might be exceedingly anxious include: regressive behaviors, nightmares or other sleep-related issues, irritability, difficulty making transitions, unwillingness to enter into play, extreme difficulty in separating from parents, changes in appetite and fearful of going to school.

When we look at the possible causes of anxiety in children, we need to consider the following possible reasons: genetics, exposure to a traumatic personal experience, witnessing a natural disaster or a violent event, bullying, and over placement in school or a potential leaning issue (to just name a few). In the absence of any of these, the cause could also be related to some stress within the family. This is in no way intended to place blame on parents. Any of us who have raised children of our own know that it is a very difficult role and truly a situation where “only he who is without sin is permitted to cast stones.” Rather the intent is to be helpful to parents seeking solutions.



Here are some simple suggestions of things to avoid: Protracted discussions about adult worries, loud arguments between parents and/or siblings, extensive exposure to the 24-hour news cycle, and granting children access to social media.

A child’s ability to process alarming information is completely different from an adult. For instance, when a young child sees repeated photos of a massive fire consuming a building, they do not process the fact that it is the same building and the same fire being shown over and over again. They process it as multiple scary fires. Additionally, remember that children are in the process of developing the necessary skills to problem-solve, and your primary role is as their protector.  Lower your expectations of independence and. Make confident statements of support and shared responsibility such as: “This looks hard, let’s work on it together.”



Praise small victories. In a busy family getting everyone (including yourself) out the door and at work on time can be very stressful. If your anxious and dawdling child makes mornings particularly challenging and one fine day they decide to cooperate, celebrate that victory! If your child is suffering from anxiety, recognize it and tell them that you know they are unhappy and that you are going to “figure it out together.”



Effective treatment of children always involves the whole family. The entire family will need to participate in the therapy and will all realize a tremendous benefit from it. Anxiety is a very treatable issue and early diagnosis and effective treatment can be life-altering.


If you have additional questions or concerns about your child, feel free to contact us at and we will be happy to help you.