What Anxiety Disorders Look Like in Children
Learn the most common symptoms of Generalized Anxiety Disorder in children, as well as warning signs that may point to OCD, panic disorder, or another related anxiety disorder.
Many parents worry that stress and anxiety are growing more prevalent and poisonous in their kids’ lives. This may be true, however it’s also true that moderate anxiety helps children push themselves to succeed at home and in school. It is normal to feel anxious when taking a test or performing in the school play. We expect children to be nervous at the doctor’s office or when faced with a new situation.
When most people speak of anxiety, they are referring to Generalized Anxiety Disorder (GAD), which we cover in more depth below. But several other types of anxiety disorders also impact children:
1. Body-Focused Repetitive Behaviors (BFRBs) are related to self-grooming, anxiety management, or sensory stimulation. The most common BFRBs are trichotillomania (hair pulling), dermatillomania (skin picking), onychophagia (nail biting), dermatophagia (skin biting), rhinotillexomania (nose picking), as well as cheek biting and joint cracking.
2. Obsessive-compulsive disorder (OCD) causes children to experience pervasive, unwanted obsessions or worries. Sometimes, they work to relieve this anxiety through repetitive physical or mental behaviors called compulsions.
Among kids and teens with OCD, common obsessions include:
- fear of dirt, germs or contamination
- a need for symmetry, order, and precision
- religious obsessions
- lucky and unlucky numbers
- sexual or aggressive thoughts
- fear of illness or harm coming to oneself or family
- intrusive sounds or words
These compulsions are also common among kids and teens with OCD:
- grooming rituals, including hand washing, showering, and teeth brushing
- repeating rituals, including going in and out of doorways, needing to move through spaces in a special way, or rereading, erasing, and rewriting
- checking rituals to make sure that an appliance is off or a door is locked, and repeatedly checking homework
- ordering or arranging objects and cleaning rituals around the house
- counting rituals
- hoarding and collecting things of no apparent value
3. Panic Disorder is characterized by the sudden onset of intense fear, called a panic attack, followed by weeks of worry about having another similar attack. Symptoms include: difficulty breathing, racing heart, sweating, needing to escape, sense of danger or doom, and chest pain, among others.
4. Post Traumatic Stress Disorder is an anxiety disorder that can develop after involvement in or exposure to a frightening, traumatic event. Symptoms include ongoing upsetting memories, nightmares, flashbacks, feeling overly jumpy or irritable, and avoiding reminders of the incident.
5. Social Anxiety Disorder causes children and teens to fear social and/or performance situations because they worry about doing something embarrassing or being negatively judged by others. The extreme manifestation of this is the rare condition Selective Mutism.
6. Separation Anxiety Disorder causes children to worry excessively about being separated from primary caregivers or from the home.
7. Specific Phobias involve persistent, over-the-top fears of an object or situation that is beyond the child’s control and significantly impacts life. Common phobias include insects, heights, dogs, and loud noises.
Common Symptoms of Generalized Anxiety Disorder for Children at Home
If you notice the following warning signs, schedule an appointment with your child’s doctor:
- Trouble falling asleep
- Fear of being alone
- Picking at skin
- Nail biting
- Strong startle response
- Being overly self-critical
- OCD-like behaviors (e.g. checking and rechecking the door to make sure it is locked or arranging objects “just so”)
- Suddenly avoiding social contact
- Frequent urination
Common Symptoms of Generalized Anxiety Disorder for Children at School
According to Child Mind Institute, your child’s anxiety may manifest at school in several ways. Keep an eye out for these signs:
- Refusing to go to school or having a hard time at school drop-offs
- Difficulty participating in class and interacting with peers
- Excessive worry about everyday things
- Trouble answering questions when called on by the teacher
- Disruptive behavior
- Frequent trips to the nurse (with complaints of headaches, nausea, stomachaches, or even vomiting)
- Avoiding socializing or group work
- Not turning in homework
If you notice several of the above, ask your child’s doctor to perform an in-depth screening of his mental and physical health to rule out depression, ADHD, or a specific phobia, all of which can look like GAD. Certain physical conditions, like thyroid disorders or heart conditions, can also mimic anxiety-like symptoms. Your doctor can rule out most of these with simple blood and urine tests — though some more complicated conditions may require x-rays or physical stress tests.