October 24, 2023

Childhood anxiety: What parents need to know

A child and adolescent psychiatrist shares tips on supporting your child — and when it’s time to reach out for help.

If a child or teen withdraws from activities they once enjoyed, that could be a sign of anxiety.

Every child experiences worry and even fear from time to time. These emotions can be triggered by anything from watching a scary movie to studying for an exam.

But when worries persist or become extreme, they may be a sign of anxiety.

Even before the start of the COVID-19 pandemic, rates of childhood anxiety were high, with anxiety disorders affecting about 3 of every 10 adolescents age 13 to 18.

Rates of anxiety have continued to grow since 2020 as young people cope with loneliness and loss, the pressures of social media, and worries about school safety.

Karen Stewart, MD, is a child and adolescent psychiatrist for Kaiser Permanente in Georgia. She shared advice on how parents can support kids who are struggling with anxiety.

How is anxiety different than normal stress and worry?

It’s natural for young people to worry about things like friendships or school. But with an anxiety disorder, that worry is out of proportion. People become unable to manage their day-to-day lives.

Anxiety can negatively affect sleep and concentration. It can also cause physical complaints, such as muscle strain, headaches, and stomachaches. Some people get so anxious that they don’t want to participate in their usual activities.

How does anxiety show up in kids and teens?

One of the things parents should look out for in younger kids is a change in behavior. If you have a child who is normally active and outgoing, and they withdraw and stop taking part in their usual activities, that could be a sign of anxiety.

Anxiety can also show up in nightmares.

Some kids will talk about death and other bad things happening to family members or to themselves.

If you have a kid who wasn’t having a problem going to school, and suddenly they don’t want to go, that’s another sign.

Teens who are anxious may withdraw from their peer group.

Declining grades and fluctuating school attendance are another sign.

We get especially concerned when we see teens using drugs and alcohol to decrease their anxiety.

How can parents support a child who has anxiety?

The most important thing is to establish a relationship with your child where you can have honest conversations. That makes them comfortable coming to you when they’re having problems.

Don’t wait to raise concerns. If you notice something is off, have a sit-down and ask what’s causing the changes you’re seeing.

Setting realistic expectations about school is also important. Teens often feel pressure from parents to make straight A’s and get everything in on time. Try to focus on progress rather than perfection.

When should parents turn to a mental health professional for support?

When you see anxiety affecting your child’s grades or their ability to do the things they enjoy, it’s time to get a professional involved. Your child’s doctor can help connect you to services.

A lot of families feel intimidated by the idea of an assessment. They don't want their child to be labeled or prescribed medication for anxiety. But for the most part, we use therapy as our first line of treatment.

How does Kaiser Permanente support kids with anxiety?

We support kids and teens with a range of mental health services. At one end of the continuum, we offer self-care apps like Calm at no additional cost. Members age 13 and up can use the apps to access tools like mindfulness activities and breathing exercises.

We also offer individual and group therapy. Therapy can help children develop the skills they need to cope with anxiety.

In some cases, medication can be effective for kids with anxiety. We offer medication management to closely monitor how they’re doing.

For children coping with severe anxiety, we have more intensive programs.

Anxiety is very treatable. When kids connect with mental health professionals and get the support they need, they do get better.

Learn more about supporting your child’s mental health, and complete a mental health symptoms checker for parents.