What to Do for Anxiety in Children

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Shy young boy holding onto mother's leg

Anxiety is excessive worry and uneasiness that interferes with normal activities and relationships. The cause is often not immediately apparent. When a child has anxiety, it’s natural for parents to feel scared, overwhelmed or isolated. But the condition is more common than you may think: One in eight children has an anxiety disorder.

Parents whose children show symptoms of anxiety want to help but don’t always know what to do or where to turn. This guide can help you make sense of the available treatment options and includes some low-tech tips you can start using right away.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is a type of talk therapy that teaches children how to identify and replace unhelpful thoughts. In cognitive behavioral therapy, kids learn different ways of thinking about and reacting to anxiety-provoking situations. CBT is effective in children as young as 6, and can help a child within weeks or months. Most children need between 5 and 20 therapy sessions. Each session typically lasts about 30 to 60 minutes.

CBT can take place one-on-one or in group sessions. You can also find CBT programs online. CBT sometimes includes exposure therapy, or gradual exposure to the object of your child’s fear or anxiety.

According to some studies, CBT is as effective as medication in treating anxiety. Unlike medication, CBT has no physical side effects. CBT requires commitment and effort. It is unlikely that CBT will be successful unless the child actively participates in the treatment.

Medication

Medications commonly used to treat anxiety in children include antidepressants, anti-anxiety medications and beta-blockers, a type of medication typically used to treat heart conditions but also can control the fast heart rate and other physical symptoms that often accompany anxiety. Because all medications have side effects, medication is rarely prescribed as a first treatment for anxiety. Medication is most often used when other interventions have not been successful, or as a complement to therapy.

  • Antidepressants increase the levels of serotonin, a naturally occurring feel-good chemical in the brain. These medications take weeks to reach their full effectiveness. Anyone taking an antidepressant should be closely monitored, especially in the first few weeks.

  • Anti-anxiety medication is used to relieve the symptoms of anxiety and panic attacks. These medications are usually used as-needed, when symptoms occur.

  • Beta-blockers are particularly useful for controlling the physical symptoms of anxiety and are often used to treat social anxiety.

Medication may allow your child to participate in activities he or she would otherwise avoid. Medication can help get symptoms under control while a child is learning new coping techniques in therapy. Side effects include feelings of agitation, dizziness, upset stomach, blurred vision, sleepiness and headaches. Rarely, antidepressant medication can cause suicidal thoughts. Ask your child’s doctor about the risks and benefits of any suggested medication. Also ask about follow-up appointments and medication monitoring.

At-Home Interventions for Anxiety

In addition to professional treatment, there’s a lot you can do to help your child cope with anxiety. You can:

  • Teach your child to recognize the symptoms of anxiety. Young children often don’t recognize their physical symptoms—upset stomach, racing heart—as signs of anxiety. By helping your child to recognize these feelings as signs of anxiety, you eliminate the all-too-common fear that he or she is sick or dying. You can also teach your child to begin using coping strategies when these symptoms occur.

  • Validate, but don’t escalate. You can’t talk someone out of an irrational fear. Let your child know you hear and are empathetic to her fear, but don’t reinforce your child’s fears with your words or body language. If your child is afraid of immunizations, it’s not helpful to say, “Lots of people are! Those needles are so big and scary!” It’s better to matter-of-factly reflect your child’s words: “Yes, I know you’re afraid of shots.”

  • Help your child tolerate anxiety. Anxiety is a part of life, and impossible to avoid. You can help your child by supporting her through brief periods of anxiety, and then praising her for her efforts.

  • Practice simple relaxation techniques. Techniques such as distraction and deep breathing can help, depending on your child’s age.

  • Model healthy coping. A child who sees his parents take some deep breaths to calm down may learn to do the same.

Helping your child deal with anxiety is often a trial and error process. With some experimentation and professional help, you’ll eventually find the treatment and coping strategies that work best for your child and your family.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Jun 20

  1. Anxiety Disorders in Children. National Health Service. http://www.nhs.uk/Conditions/anxiety-children/Pages/Introduction.aspx#treatment

  2. Cognitive Behavioural Therapy. National Health Service. http://www.nhs.uk/conditions/Cognitive-behavioural-therapy/Pages/Introduction.aspx

  3. Selective Serotonin Reuptake Inhibitors (SSRIs). National Health Service. http://www.nhs.uk/Conditions/SSRIs-(selective-serotonin-reuptake-inhibitors)/Pages/Introduction.aspx

  4. Anxiety Disorders. National Institutes of Mental Health. http://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml

  5. Tips for Parents and Caregivers. Anxiety and Depression Association of America. http://www.adaa.org/living-with-anxiety/children/tips-parents-and-caregivers

  6. What to Do (and Not Do) When Children are Anxious. Child Mind Institute. http://childmind.org/article/what-to-do-and-not-do-when-children-are-anxious/

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