Anxiety Disorders in Children and Adolescents
Anxiety disorders are among the most common mental health conditions affecting children and adolescents. These conditions can significantly influence emotional wellbeing, social development, and academic performance. Early identification, diagnosis, and treatment are important in helping reduce long-term difficulties and improving overall quality of life.
Predisposing Factors
The development of anxiety disorders in young people is influenced by a combination of genetic, biological, psychological, and environmental factors.
Genetic Factors
- A family history of anxiety or other mental health conditions increases vulnerability.
- Children may inherit a biological tendency toward heightened stress reactivity or abnormal stress-response functioning.
Biological Factors
- Imbalances in neurotransmitters such as serotonin, dopamine, and GABA may contribute to anxiety symptoms.
- Overactivity of the amygdala or dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis can heighten anxiety responses.
Psychological Factors
- Cognitive distortions, including catastrophic thinking or overestimating threat.
- Avoidance behaviours, which can reinforce fear and maintain anxiety patterns over time.
Environmental Factors
- Parenting styles characterised by overprotection or criticism.
- Stressful or traumatic life events such as bullying, loss, parental separation, or major change.
- Chronic illness or disability leading to increased emotional stress.
- Difficult peer relationships or social rejection.
Common Anxiety Disorders in Children and Adolescents
- Generalised Anxiety Disorder (GAD)
- Social Anxiety Disorder
- Separation Anxiety Disorder
- Specific Phobias
- Panic Disorder
- Obsessive-Compulsive Disorder (OCD)
Signs and Symptoms
Anxiety in children and adolescents may present differently than in adults and can appear through physical, emotional, behavioural, and cognitive symptoms. Severity can vary and may significantly interfere with daily functioning.
Physical Symptoms
- Headaches, stomachaches, fatigue
- Sleep difficulties or nightmares
- Muscle tension or trembling
- Rapid heartbeat or sweating when anxious
Emotional Symptoms
- Excessive or persistent worry
- Fear of separation from caregivers (especially in younger children)
- Irritability or mood changes
- Feelings of inadequacy or low self-esteem
Behavioral Symptoms
- Avoidance of anxiety-provoking places or situations
- Perfectionism and difficulty coping with mistakes
- Clinginess or refusal to attend school
- Tantrums or frequent crying in younger children
Cognitive Symptoms
- Catastrophic or fear-based thinking
- Difficulty concentrating due to worry
- Hypervigilance or heightened alertness to perceived threats
Diagnosis
Diagnosis typically involves a comprehensive clinical assessment, which may include:
- detailed clinical interview
- behavioural observations
- screening for co-occurring or alternative conditions (such as depression, ADHD, or medical causes)
Treatment
Treatment for anxiety disorders in children and adolescents is usually individualised and may include therapy, medication, and supportive lifestyle strategies, depending on severity and developmental needs.
Cognitive-Behavioural Therapy (CBT)
Considered the leading evidence-based treatment, CBT helps children understand anxiety patterns and develop coping strategies.
Exposure Therapy
A structured CBT-based approach that gradually exposes children to feared situations in a safe and controlled way to reduce anxiety responses.
Medication
May be used alongside therapy in cases of severe or persistent symptoms, based on clinical judgement.
Parent and Family Involvement
- Supporting healthy coping responses rather than reinforcing avoidance
- Family therapy where relational dynamics may influence anxiety
School Support
- Encouraging a supportive learning environment
- Promoting peer connection and social skill development
Lifestyle Modifications
- Regular physical activity
- Relaxation and mindfulness techniques
- Good sleep habits to support emotional regulation
