Anxiety prevails across ages and has varying risk factors, concerns, and symptom presentations according to the life stage. Younger patients, including adolescents and young adults, experience higher incidences of anxiety often linked to elements like relationship disorders, childhood maltreatment, and stress. 

Older adults experience fewer excessive concerns but display age-related differences in the content of the concern, such as increased worries about health, community, and loved ones. 

• Anxiety across ages (children, teens, and young adults) is generally in the categories described below: 

• A higher prevalence has been noted in younger age groups between 16 and 29, as they are more likely to experience anxiety. 

• The risk factors associated with anxiety in teenagers include childhood maltreatment, stressful life events, and genetic liabilities. 

• Anxiety in children appears as a persistent worry that interferes with daily life, like attending school or meeting friends. Also familiar are physical symptoms in this age group that are sometimes mistaken for medical illnesses. 

• The mean age for the onset of childhood anxiety, such as separation anxiety or specific phobias, is before age 15, with others appearing during young adulthood. 

Anxiety in Older Adults 

• Older adults may experience different patterns of anxiety despite the prevalence of anxiety disorders remaining comparable to those of younger adults. 

• Older adults often worry about specific concerns, such as their personal health, community affairs, and the well-being of their loved ones. 

• Physical impairments leading to isolation also contribute to anxiety. Grief from the loss of a loved one is a more frequent trigger in older age. 

• Physical symptoms of anxiety are more challenging to diagnose among older adults because the symptoms appear like other medical conditions, making early identification a challenge. 

Throughout the Lifespan 

• For some, persistent fear, concerns, and anxiety are symptoms of anxiety disorders, especially when they disrupt daily life significantly. 

• Strategies such as parental education, school-based programs that focus on social and emotional learning, and exercise programs help prevent anxiety across various age groups. 

• Unhealthy lifestyle factors such as excessive caffeine and alcohol consumption can also exacerbate anxiety disorders. 

Anxiety in Children 

Anxiety in children is identified as a disorder if concerns and fears interfere with their lives for more than six months. It may be challenging to determine whether your child is anxious. They might complain of falling sick and be irritable, making early intervention and treatment helpful. 

Anxiety in Children Explained 

Anxiety in teenagers, coupled with fear, is normal during childhood. While fear is a natural reaction to a threat or danger, anxiety is a reaction to a perceived or potential threat. Fresh fears and anxieties are generally short-lived; ensure that children learn to cope with problems on their own. Parents and caregivers can assist children learn to understand and overcome their fears and anxieties. 

Approximately 20% of children develop what healthcare providers consider anxiety disorders. Anxiety disorders during childhood differ from generalized fear or anxiety because they may involve extreme avoidance, larger emotional reactions, or last longer than expected. Children with emotional disorders may display emotional outbursts such as crying or tantrums. They may also be keen to show avoidance and might try to hide or escape, and often be on the lookout for danger. Additionally, children also have physical symptoms such as stomachache, headaches, vomiting, nausea, breathlessness, and sleep issues. 

Versions of Anxiety in Children 

There are different versions of anxiety in children. Some of them include: 

Separation Anxiety Disorder: Separation anxiety is normal and an important phase of early development beginning in children between eight and 12 months old. With normal separation anxiety, children may fear strangers and feel unsafe when you are not around. Separation anxiety usually resolves by the time children enter school. Unfortunately, if the problem does not resolve, separation anxiety becomes more extreme and continues beyond the typical developmental period. Children may worry about parents or other family members and have difficulties going to school or being away from home or family, or may confront challenges separating to go to bed. If your child displays extreme stress or worry with separations from other children their age, and you don’t see improvements or have concerns, talk to your child’s health care provider for help. 

Specific Phobias: Fear helps protect us from danger, making some fears in children expected. Your child might express fear of a variety of things, including storms or clowns. However, extreme fears are specific phobias out of proportion with the actual threat of danger. 

Social Anxiety Disorder: SAD is an intense fear of being rejected or judged in social situations. The fear can cause children to avoid speaking in public or interacting with others. They may even avoid social situations altogether. 

Generalized Anxiety Disorder: Also called GAD, it involves excessive fear and worry about many different things that occur in daily life. Your child may also be concerned about the future more than other children their age. Their worries and concerns may change over time, but they continue to remain concerned about something. 

Panic Disorder: Children with panic disorder may experience extreme fear and anxiety with physical symptoms such as a racing heart, dizziness, or dyspnea. Panic attacks can occur without warning and typically last from minutes to hours. 

How Common Is Anxiety in Children? 

Childhood anxiety is pretty common, affecting 15 to 20% of children and adolescents. Approximately one in three adolescents between 13 and 18 has anxiety, and it is more common in females. 

Symptoms and Causes 

Signs and Symptoms of Anxiety in Children 

Parenting can appear like a guessing game. Some children use words to express their fear and anxiety to their parents. They might comment that they fear going to school because they’re concerned they will never see you again. Others may struggle to express their feelings. However, children also display signs of anxiety. They might: 

• Worry and or cry more often than other children of the same age. 

• Complain about not feeling well by pointing to a stomachache, sore muscles, or headache. 

• Confront challenges sleeping and wake up from nightmares or are unable to sleep by themselves. 

• It’s challenging for me to relax or sit still. 

• Anger easily. 

• Have challenges focusing. 

• Complain about hunger or say they aren’t hungry. 

• Tremors. 

• Refuse to go to school or use the bathroom a lot. 

Causes of Anxiety in Children 

Some children are naturally sensitive and may struggle to cope with changes or intense emotions. These children may have a genetic tendency to anxiousness. Anxiousness develops after stressful life events, and some children may have stressful events from an early age, such as: 

• The loss of someone close to them. 

• Moving to new houses or schools, especially if they are frequent. 

• Not getting sufficient food to eat. 

• Difficulties with safe places for living. 

• Challenges with consistent schooling. 

• Fighting and arguing parents with separation and divorce. 

• Bullying, abuse, or neglect. 

What Is the Primary Cause of Anxiety in Children? 

It is difficult to say for sure what the primary cause of childhood anxiety is. It is natural to fear when growing up. Some children are okay managing it, but children’s anxiety interferes with their day-to-day lives, whether genetics, biology, or family history play roles. 

Complications of Childhood Anxiety 

Children with anxiety are most susceptible to issues like depression and substance use disorders in later life. They may struggle with attending school or with their schoolwork. Children with anxiety are also at a higher risk of suicide. While the symptoms may not appear different from anxiety in seniors, it is important to remember that treatments are available for age-specific anxiety symptoms. It is essential to follow up with the child’s health care provider as often as recommended. Seek immediate medical attention or call the suicide and crisis lifeline at 988 in the US if you think your child might hurt themselves. 

Diagnosis of Childhood Anxiety 

Management and Treatment 

There are a couple of ways to treat anxiety in children. They are cognitive behavioral therapy (CBT) and medications. But treatments work by themselves, but they appear to work better together. 

Cognitive behavioral therapy (CBT): CBT helps children learn coping strategies helpful to manage bodily reactions, think differently, and confront fears and challenges in tiny steps. Children can acquire coping skills in individual or group therapies. Parents with adult anxiety symptoms can also learn about the coping skills to support their children and practice them. 

Medications 

Your child’s health care provider may prescribe selective serotonin reuptake inhibitors (SSRI) such as: 

• Prozac® 

• Paxil®, Pexeva® 

• Zoloft® 

If the medications are not effective for your child, they may prescribe a serotonin and norepinephrine reuptake inhibitor (SNRI) such as: 

Cymbalta®, Drizalma®, Irenka®. 

Side Effects of Medications for Childhood Anxiety 

Call your child’s health care provider if they develop any of the following symptoms after taking the medications prescribed for childhood anxiety. 

• Allergic reactions. 

• Body poop. 

• Fast irregular heartbeat. 

• Fainting, dizziness, chest pain, breathlessness. 

• High fever. 

• Sudden vision changes or eye pain. 

• Worsening mood or suicidal thoughts. 

There are other side effects associated with medications helpful to treat anxiety in children, but they don’t require medical attention. The side effects disappear by themselves in a few weeks and may return if your child’s dose changes. Your child’s health care provider will provide all the information to you and answer any questions you have. The other side effects include: 

• Appetite changes. 

• Challenges with sleeping or drowsiness. 

• Dry mouth. 

• Headache. 

• Tremors. 

• Upset stomach, nausea, and diarrhea. 

How Quickly After Treatment Can My Child Feel Better? 

Most families start with CBT and additional therapies if required. CBT with a parent as a core therapist or in groups is specifically helpful to teach step-by-step coping strategies to reduce symptoms and improve coping. As this therapy includes learning, children tend to learn quickly and feel better and more confident within a few sessions. Occasionally, the sessions reduce symptoms, but more help is required for children to conquer their anxiety. In such circumstances, medications are also important. 

Medications such as SSRIs and SNRIs require some time before they become effective. Additionally, not every medication works similarly in every individual. Your child’s health care provider may try one medication for a few weeks or months to observe improvements. If the medication doesn’t help, advise a different course of therapy. 

What to Expect If Your Child Has Anxiety? 

If your child has an anxiety disorder, they may appear to be irritable by clinging to you or refusing to leave home. If they are managing anxiety during pregnancy, they may need perinatal anxiety treatment, manifesting in panic attacks or generalized anxiety disorder. Treatment for childhood anxiety requires time to become fully effective. However, the treatment generally helps reduce symptoms. With appropriate treatment, children with anxiety start participating in activities that interest them and form friendships, besides finishing school and enjoying life. 

There may be periods in your child’s life when their anxiety returns to overwhelm them again. When this occurs, they may need to make adjustments to their medications or consider more frequent therapy sessions until their anxiety symptoms are better managed. 

How to Help a Teenager with Anxiety? 

Consider calling your child’s health care provider immediately if they are showing signs of anxiety or stop doing things you think they can do. Healthcare providers can teach anxiety in teenagers coping tips to your child to make them more comfortable and at ease with themselves. 

Conclusion 

Parents with children affected by anxiety disorders find it challenging to cope. It requires a grounded patient, parent, or caregiver to look at your child’s demands and irritability to determine the anxiety that drives their behavior. Occasionally, the process of determining the right treatment for your child requires time, but that is fine and not a reason to become discouraged. 

Parents must ensure they take care of themselves because they might not notice their level of stress and anxiety. However, when they notice their child’s anxiety, they must also understand they could be affected by the same as well.