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Anxiety Disorders

Anxiety is an unpleasant feeling of worry, unease or apprehension. Anxiety may be associated with specific
situations, events or objects. In some cases, medical problems can lead to symptoms of anxiety.


Dylan is afraid of the dark. Tricia hates to eat in front of other people. Eric becomes sick to his stomach and throws up if he has to speak aloud in class. Fears and worries are a very normal part of life for children and adults. However, if these worries become cause for concern because they are affecting day-to-day functioning significantly, we refer to these excessive worries as anxiety.

How Common are Anxiety Disorders?

Anxiety disorders are the most common mental health condition in children and adults. Roughly 6% of children and youth have an anxiety disorder that is serious enough to require treatment.

How Long Do They Last?

Without treatment, some of the anxiety disorders that begin in childhood can last a lifetime, although they may come and go.

What Causes Anxiety Disorders?

Anxiety disorders have multiple, complex origins. It is likely that genes play a role in causing anxiety. However, the home, the neighborhood, school and other settings can also contribute to anxiety.

For example, some babies or young children who live with too much stress can become anxious. Other children may “learn” to respond in an anxious way to new situations because a parent or other caregiver shows anxiety. In most children and young people it is a mix of these causes that leads to an anxiety disorder.

Types of Anxiety Disorders

Children and teens can have more than one type of anxiety disorder at the same time. Some types of anxiety disorders are:

Separation Anxiety Disorder

Sometimes older children and teens become frightened of leaving their parent(s). They may worry that something bad might happen to their parent or to someone else they love. It is only a
problem if there is no real reason for this worry. These young people may have a condition called Separation Anxiety Disorder.

Children with Separation Anxiety Disorder may refuse to go to school or they may be unable to go to sleep without a parent being present. They may have nightmares about being lost or kidnapped. They may also have physical symptoms like stomachaches, feeling sick to their stomach, or even throwing up out of fear. A diagnosis of separation anxiety is made if the behaviour has been present for at least four weeks and the behaviour results in real and ongoing social or school problems.

Social Phobia

Social phobia is more likely to occur in teenagers than young children. It involves worrying about social situations, like having to go to school or having to speak in class. Symptoms may include sweating, blushing, or muscle tension.

People with this disorder usually try to control their symptoms by avoiding the situations they fear. Young people with social phobia are often overly sensitive to criticism and have trouble standing up for them. They can also suffer from low self-esteem, be easily embarrassed, and be very shy and self-conscious.

Panic Disorder

Teenagers, and sometimes children, are likely having a panic attack when they feel very scared or have a hard time breathing and their heart is pounding. They may also feel shaky, dizzy and think they are going to lose their mind or even die. The teen or child may not want to go to school or leave the house at all because they are afraid something awful will happen to them. Frequent panic attacks may mean that they have a panic disorder.

Selective Mutism

This is a term used to describe the behaviour of some children who do not speak in certain situations while speaking in others. Children with selective mutism have a specific worry about speaking, but only in the situations that make them feel anxious.

Some children may speak only to their parents but not to other adults. When they know they are going to have to speak, these children may blush, look down, or withdraw. When they do communicate in such situations, they may point or use other gestures, or whisper rather than talk. Up to 2% of school aged children may have the symptoms of selective mutism and the symptoms usually appear when they start daycare or school. Some children may “outgrow” the condition but many go on to have social phobia.

Generalized Anxiety Disorder (GAD)

This is a condition in which the child or adolescent has many worries and fears. They have physical symptoms like tense muscles, a restless feeling, becoming tired easily, having problems concentrating, or trouble sleeping. Children with this condition often try to do things perfectly. They also feel a need for approval.

Obsessive-Compulsive Disorder (OCD)

Symptoms for OCD usually begin in early childhood or adolescence. Children and young people with OCD have frequent, uncontrollable thoughts (“obsessions”) that are unreasonable.

These thoughts come into their mind a lot. They then need to perform certain routines or rituals (“compulsions”) to try to get rid of the thoughts. In some situations, anxiety may be normal for a younger child but not an older one. One common example is a young child who becomes upset when left alone with a babysitter for the first time. This separation anxiety is a normal reaction for a young child but would not be normal for a teenager.

When the symptoms begin in later childhood or adolescence and continue for several weeks then it may be time to seek professional help.

Children and adolescents with this disorder will often repeat behaviors to avoid some imagined outcome. For example, some people who are frightened of germs will wash their hands over and over to avoid catching a disease. These thoughts can also cause a young person a great deal of anxiety. The obsessions and compulsions can take up so much time that the young person can’t lead a normal life.

Post-Traumatic Stress Disorder (PTSD)

PTSD is fairly rare in children. It usually involves a set of anxiety symptoms that begin after one or many episodes of serious emotional upset. The symptoms include jumpiness, muscle tension, being overly aware of one’s surroundings (hyper vigilance), nightmares and other sleep problems. Children and young people with PTSD sometimes also report feeling like they are “re-living” the traumatic experience. These “flashbacks” often include vivid memories of the triggering event(s), which may involve physical, emotional or sexual abuse.

How is Anxiety Treated?

Anxiety treatments include:

  • Cognitive behavioural therapy (CBT) has been shown to be effective in the treatment of anxiety disorders in children. CBT is considered to be the treatment of choice. If an older child or adolescent does not respond completely to CBT, then medications can be added.
  • Anti-anxiety medications such as selective serotonin reuptake inhibitors (SSRIs) help by regulating brain chemicals.

Anxiety is an unpleasant feeling of worry, unease or apprehension.