Marin County Psychological Association
Marin County Psychological Association

Anxious Children and Teens

Author: Dr. Tracy Ryaru

Anxiety is a natural part of childhood. In fact countless daily experiences can trigger anxiety. Although it may sound odd at first, some anxiety is actually beneficial. For example, anxiety about getting burned may cause children to avoid hot stovetops. However, anxiety may also have incredibly challenging effects.  For some children and teens anxiety significantly interferes with school, family relationships, friendships and other important parts of their lives. When anxiety profoundly impacts the life of a child or teen an anxiety disorder may be present.

Anxiety Disorders

Approximately 1 in 8 children (under age 18 years old) develop an anxiety disorder (“Children and Teens,” n.d.). According to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5), children and teenagers sometimes experience the following anxiety disorders:

Separation Anxiety Disorder: Children, and sometimes teens, experience significant fear and anxiety about separating from people with whom they are closely attached (e.g., parent, caretaker). This could include an intense fear about leaving a parent to attend school. Separation Anxiety Disorder refers to a level of fear and anxiety that is well beyond what is expected given the age of the child (5th ed.; DSM-V; American Psychiatric Association; 2013).

Selective Mutism: Children, and sometimes teens, consistently do not speak in situations where speaking is expected, but do speak in other situations. For example, a child may not speak at school but speaks without hesitation at home (5th ed.; DSM-V; American Psychiatric Association; 2013).

Social Anxiety Disorder (also known as Social Phobia): Children and teens are extremely fearful of interacting with others, especially in situations where there is the possibility of being criticized (5th ed.; DSM-V; American Psychiatric Association; 2013).

Specific Phobia: Children and teens experience significant fear about specific objects and situations. For example, a teenager may be extremely fearful of dogs, and as a result put tremendous effort into avoiding all situations where dogs might be present (5th ed.; DSM-V; American Psychiatric Association; 2013).

Agoraphobia: Children and teens experience intense fear or avoidance of a variety of situations. This may include public transportation, open spaces, enclosed spaces, etc. For those who have agoraphobia, the situation is frightening because they believe something horrible will happen. For example, they may feel like escape would not be possible, something embarrassing may occur, or that there would be no help should panic symptoms begin (5th ed.; DSM-V; American Psychiatric Association; 2013).

Panic Disorder:  Children and teens experience repeated panic attacks that include intense fear of having another panic attack, feeling like they are “going crazy” and/or changing behavior to avoid things that may trigger an attack. Panic attacks are time limited and involve a variety of symptoms, including, but not limited to heart palpitations, increased heart rate, sweating, trembling, shaking, chest pain, shortness of breath, dizziness, and/or fear of dying (5th ed.; DSM-V; American Psychiatric Association; 2013).

Generalized Anxiety Disorder: Children and teens experience extreme worry about multiple parts of life that are difficult to control, and the amount of worry exceeds what would be expected (5th ed.; DSM-V; American Psychiatric Association; 2013).

Causes of Anxiety Disorders

The exact causes of anxiety disorders are not yet fully understood. However, what is known is that anxiety appears to be triggered by a combination of stress and genetics (“Anxiety: Causes,” 2012). Children and teens experience a variety of stressors, including but not limited to, challenging relationships with peers, family difficulties, learning differences, grief/loss, trauma and medical challenges. Also, children and teens with a family history of anxiety are more likely to develop an anxiety disorder.

Treating Anxiety Disorders

Parents should seek guidance from a mental health professional if the anxiety that their child or teen is experiencing is interfering with his/her typical activities (“The Anxious Child,” 2012). A range of options exist to help children and teens with anxiety. A mental health professional can assist clients with determining the best treatment approach given the presenting symptoms. These may include specific types of therapy, or medications, or a combination of the two. Psychological assessments may also be used to learn more about the type of anxiety present, including underlying difficulties that may be contributing to the anxiety. They can then serve as a “road-map” to give increased direction to therapy. It is important that anxiety disorders be treated as soon as possible in order to prevent challenges in the future, such as academic difficulties, friendship challenges and/or decreased self-esteem (“The Anxious Child,” 2012).


Below are MCPA Members with specialties in this area: