What is anxiety?
Anxiety is a feeling of fear, worry, nervousness or unease. It acts as the body’s alarm system to warn us when there may be a threat. When faced with a threat, our body thinks there are only two choices: to fight the threat or flee from it.
Anxiety is a normal part of life. Every child feels anxiety at some point. Feeling some anxiety related to a stressful situation or event is a normal response. As long as the anxiety is temporary (e.g., a few concerns or questions from time to time), and does not interfere in your child’s day-to-day life (e.g., they continue to be engaged in activities, are eating and sleeping well) then it should simply be monitored.
Many anxieties are a part of growing up and usually pass. They usually occur in response to particular situations, such as a test, a class presentation or a move to a new school. Typically, they last for a short time, for example days or weeks.
What is an anxiety disorder?
An anxiety disorder occurs when anxious feelings or worry become overwhelming for your child. They can affect your child's appetite, sleep or mood and, in turn, interfere with their daily activities and overall enjoyment of life.
More information about anxiety and anxiety disorders
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What causes an anxiety disorder?
The exact causes of an anxiety disorder are not clear, but a number of risk factors usually exist.
Biological factors
Biological factors include our genes, as many anxiety disorders run in families.
Temperamental factors
Temperamental factors relate to a child's temperament, for instance if they are naturally anxious or sensitive. This is usually obvious from a child’s infancy, for instance being more anxious or sensitive to a variety of things from a very young age.
Social or environmental factors
Social and environmental factors include experiences such as bullying, illness, problems at school, arguments with friends and major changes in the family such as moving house or the divorce of parents.
Anxiety does not result from any single risk factor of those listed above. Instead, it occurs when several factors occur together.
How common are anxiety disorders in children?
Anxiety disorders are the most common mental health disorder in children. About 10 to 20 percent of children and teens will develop an anxiety disorder.
Does anxiety occur with other conditions?
Yes, several anxiety disorders can occur together. Anxiety can also often occur with other conditions, including:
- oppositional defiant disorder (ODD)
- ADHD
- learning disabilities
- depression
- substance use disorders
- eating disorders such as anorexia, bulimia or binge eating disorder
- bipolar disorder
How to help your child with anxiety
- Take time to listen to your child and understand their fears and worries. Answer questions directly and honestly and do not make false promises.
- Help your child understand that anxiety is normal and can be faced.
- Reassure and encourage your child to face what they fear, but resist providing too much reassurance. Let them know that it is OK and understandable to have these feelings.
- Resist accommodating your child's anxiety. In other words, do not let your child avoid situations that cause them anxiety.
- Look at your own anxiety levels to see if they might be affecting your child. During times of stress, make sure to attend to your own physical and mental health.
- Make sure to be a role model for good coping strategies for your child, for instance by facing your own fears.
- Share "need to know" information with your child, using age-appropriate language.
- If your child's anxiety seems excessive or is worsening, seek professional advice.
When to see a health-care provider about your child’s anxiety
See a health-care provider if your child’s anxiety:
- is persistent and does not improve after you have provided encouragement and reassurance
- interferes strongly with your child's everyday activities, such as preventing your child from attending school, after-school activities or even fun activities such as play dates
- disrupts your family routine, for example if your child cannot sleep alone or be alone in an area of the home or if your child's ongoing need for reassurance prevents you from enjoying family activities.
A physician, nurse practitioner or psychologist can diagnose your child based on typical signs and symptoms.
Go to your nearest emergency department if your child is experiencing suicidal thinking or behaviour.
Further information
For more information on anxiety disorders, please see the following pages:
Anxiety: Treatment with medications
Anxiety: Treatment with psychotherapy and lifestyle changes
These pages on our teen site discuss stress, how it impacts the body as well as anxiety and anxiety disorders:
Resources
Kids Help Phone – kidshelpphone.ca
Kids Help Phone is a 24/7 e-mental health service offering free, confidential support to young people.
Stress: How to help the young person in your life
Virtual care services for children:
Boomerang Health was opened by SickKids to provide communities in Ontario with greater access to community-based services for children and adolescents. For more information on virtual care services in Ontario to support anxiety, visit Boomerang Health powered by SickKids.
Books
The following books offer useful advice and information about anxiety.
To use with your child:
Benoit D, Monga S (2018). Taming Sneaky Fears - Leo's Story of Bravery & Inside Leo's Den: The Workbook. FriesenPress.
Benoit D, Monga S (2018). Apprivoiser les Peurs-pas-fines – L’histoire de bravoure de Léo le lionceau & Dans la tanière de Léo: le cahier de travail. FriesenPress.
Huebner, D. (2005). What to Do When You Worry Too Much: A Kid’s Guide to Overcoming Anxiety. Magination Press.
For parents to read:
Manassis, K. (2015). Keys to Parenting Your Anxious Child. Third edition. New York, NY: Barron’s Educational Series, Inc.
Rapee, R., et al (2008). Helping Your Anxious Child: A Step-by-Step Guide for Parents. Second edition. Oakland, CA: New Harbinger Publications, Inc.
Sheedy Kurcinka, M. (2015). Raising Your Spirited Child: A Guide for Parents Whose Child is More Intense, Sensitive, Perceptive, Persistent, and Energetic. Third edition. New York, NY: HarperCollins Publishers.
Foa, E.B., & Wasmer Andrews, L. (2006). If Your Adolescent Has an Anxiety Disorder: An Essential Resource for Parents. New York, NY: Oxford University Press