Mental Health in Children

Age of Innocence – Or Anxiety for Today’s Kids?

From loud claps of thunder to dogs that can bite, a child’s world is filled with new, sometimes scary experiences. However, if fears can’t be managed with reassurance or distraction and persistently interfere with daily activities, your child may have an anxiety disorder. These most common childhood mental health disorders are now regularly screened for in children ages 8-18, and include:

  • Generalized anxiety disorder: excessive worry about everything that’s happening in their world; focus on failures rather than successes.
  • Social anxiety disorder: intense fear of doing or saying the wrong thing; shy, withdrawn, self-conscious; avoids social and performance situations.
  • Panic disorder: suffers from unexpected panic attacks, described as “going crazy” with severe feelings such as “I feel like I’m going to die.”
  • Separation anxiety disorder: worries about something bad happening when not with caregivers, difficulty sleeping on own, excessive homesickness; may avoid playdates, sleepovers.
  • Specific phobias: intense, irrational fear of a specific object or a situation such as animals, storms, heights, water, blood, the dark, and medical procedures.
  • Selective mutism: inability to talk when faced with new people or places, but have no trouble speaking in situations where they feel comfortable.

Symptoms of Anxiety in Children

Anxiety in children manifests in numerous ways: crying, tantrums, clinging, headaches, stomach aches, shortness of breath, sleep problems, under- or overeating, and poor school performance.

Treatment of Anxiety in Children

Exposure and response prevention (ERP) therapy – exposing children to the things that trigger their anxiety in structured, incremental steps and teaching them how to master their fear – has proven very effective. When appropriate, ERP therapy can be combined with anti-anxiety medications (SSRIs).

Fear Factor: Helping Children Understand and Manage Their Fears

The frequently experienced fears shown below can often be managed with education, exploration through play, and “bibliotherapy,” the use of reading aloud to children to address their worries. In a pilot study of a four-week bibliotherapy intervention for young children with persistent and interfering nighttime fears, clinically significant change in anxiety severity was reported. Additionally, increases in the number of nights children slept in their own bed, and decreases in child-reported nighttime fears were observed.

Try it: Magination Press, the children’s book imprint of the American Psychological Association, offers a large selection of literature designed to help families navigate life’s challenges. For example, in Booma Booma Boom, a boy guides his stuffed animals through a thunderstorm using sensory-based mindfulness to ease fear, find quiet, and understand that storms also bring good things, such as calming rain and water for plants.

Age Years Common Fears
1 Separation, falling, animals/insects, toilet training, bath
2 Separation, noises, toilet training, bath, bedtime
3 Animals/insects, bedtime, monsters/ghosts, getting lost
5 Animals/insects, monsters/ghosts, divorce, getting lost, loss of parent
7 Separation, noises, falling, bedtime
9 Social rejection, war, new situations, adoption, bodily injury, school performance
10 World disasters (tsunamis, earthquakes, sinking ships)
12 Falling, burglars, bodily injury
14 Adoption, burglars, injections, sexual relations
Older Teens Social affairs, death, and illness

Adapted from: UptoDate Overview of Fears and Phobias in Children and Adolescents
Sources: Child Mind Institute, CDC, Anxiety and Depression Association of America (ADAA), UptoDate