Spencer complains of stomach aches before school, but acts fine on the weekends. Mary loves dancing, but lately she has been crying and dragging her feet to dance class ever since her best friend quit. Tommy does not make eye contact with anyone at school, is mute in front of strangers, and refuses to participate in any activities at school, including assignments. Susie is so scared of a video game she heard about from friends that she could no longer sleep in her own room even though she is 10 years old.
Are these children acting defiant about going to school, faking it to get out of something they don’t want to do, and being illogical and immature? Or, are they all exhibiting different signs and symptoms of anxiety?
Many kids don’t come out and say that they’re anxious. I worked with many children who actually didn’t know that they were feeling anxious, let alone being able to communicate it to parents and effectively problem solve. So, what are some things to look for when wondering if a child has anxiety?
Signs of Anxiety in Kids: About the Anxiety Disorders
First, it’s important to understand that there are many different kinds of anxiety disorders and they each come with different diagnostic criteria and ways they manifest themselves in kids. I won’t go in depth with each of them, but instead I will give a brief summary of the disorder.
Children can have Separation Anxiety Disorder, which is an intense fear of separation from caregiver. It might be difficult for children to leave parents to go to school or a friend’s house or they might have fears of harm befalling family members.
Social Anxiety Disorder is also common in children, which is basically feelings of shyness to such an extreme that it is difficult to go to and and interact with others at school or social events.
Many children have Generalized Anxiety Disorder; kids with this form of anxiety have many different fears on many days. Fears could include fears of flying in an airplane, of substitute teachers, or of scary video games. They can have fears related to the future as well.
Children can also have panic attacks (also known as anxiety attacks) where they might have a racing heart, difficulty breathing or shortness of breath, or feelings of dizziness, among other symptoms.
Of course, the list doesn’t end here. Post traumatic stress disorder is common when one experiences a trauma. Phobias are also a possibility.
Even if symptoms of anxiety don’t meet the necessary criteria of a disorder, anxiety can still disrupt personal and family life and be a big trial to everyone involved. Anxiety falls on a spectrum; of course we all feel some anxiety at times, but for some people the feelings are intense, long-lasting, and severe. Help and resources can still be available even if it doesn’t 100% meet the criteria of one of the above disorders or another one.
Coinciding Disorders and Similar Disorders
Anxiety often coincides with other disorders such as depressive disorders, Autism, and even ADHD. Children can also pick at their arms or pull their hair to such an extent that they meet criteria for another disorder. Mental health disorders can all get mixed up together and cause a lot of discomfort in a child and his/her family.
To make it even harder to distinguish, anxiety and other disorders, such as Autism, Depression or Obsessive Compulsive Disorder, can masquerade as each other and it can be difficult to determine what is the true cause.
Miscellaneous Signs of Anxiety in Kids
In addition to the diagnostic symptoms required to meet these various anxiety disorders, there are other, miscellaneous symptoms that may be present. They can be helpful to know when trying to determine if a child has anxiety.
Physical Complaints such as Stomach Aches and Head aches
A very high percentage of children I met with that were diagnosed with an anxiety disorder complained of stomach aches. No, this does not mean that children make it up to try to get out of something they don’t want to do. It can be a real feeling for them. Some cultures actually describe more physical symptoms than emotional or mental when describing a disorder, and I believe this is often true of children.
Oftentimes kids don’t have the emotional awareness and language to label emotions. Think of how adults often describe anxiety as feeling a pit in one’s stomach, butterflies in a stomach, or even feeling queasy when anxious. We know that we aren’t sick when we feel anxious, but kids might not know the difference. They oftentimes label feelings of anxiety as a stomach ache.
- One tip: help children learn to recognize what anxiety feels like. Assist them in naming the emotion and understand that it’s not a shameful thing to feel anxiety.
Not Wanting to Go To School, Other Places and/or Avoiding People
When children don’t want to go to school it can oftentimes be a symptom of anxiety and not strictly an act of defiance. Many children I’ve worked with have cried about going to school, and sometimes the crying starts even the night before. Kids can also become avoidant of certain people. They may no longer want to go to someone’s house, go to a birthday party, or don’t want to talk to an extended family member.
- One tip: have a heart-to-heart chat with kids. Be interested in their life and in their feelings. Dig deep and wonder about what is going on. Instead of taking behaviors at face value, hypothesize about what is going on with friends, their school workload, with teachers and with other extracurricular activities.
Changes in Behavior or Personality (Moodiness)
Anxiety can often be masked by other emotions. It can often coincide with depression. They may be more moody or sad or tearful. Kids can also act more defiant, angry, or irritable when they are struggling with other feelings such as depression or anxiety. So, if kids are acting differently than they normally do, ask yourself if it is a sign that something else is going on underneath it all.
- One tip: Just like mentioned above, spend time with children playing and talking with them in order to find out more about what is going on. In addition to that, make notes about what you notice. How often are they yelling at their siblings? Do they spend a significant amount of time in their room alone? How often do they cry about going to school and for how long?
Others Possible Signs of Anxiety in Kids to Look For:
- changes in sleeping
- endless lists of “what if’s”
- physical manifestations of anxiety such as tense muscles or rapid breathing
- anxiety about perfectionism: fear of making mistakes or being wrong
- does not want to participate in activities or assignments
- low self esteem as a consequence of some of these symptoms and behaviors
Additional Resources for Anxiety for Kids
To learn about 5 of my favorite tips for working with kids with anxiety, read our post about how to help kids cope with anxiety.
There are many various workbooks and children’s books that can be useful tools. You can read our post about some of these books here. You can also search for them and find reviews from other parents and therapists.
There is much information about each of these disorders and a simple search will reveal the list of criteria for each. A licensed professional therapist can complete a full assessment to determine if a child has any of these disorders. Please remember these signs are possible symptoms of anxiety. That does not rule out other possible causes, nor does it guarantee anxiety. Please seek the help of a licensed professional if anxiety is more than feels manageable at home or if serious harm to self or others is suspected. They can create a tailored program to help teach skills. There may also be classes or other resources available in your community. Remember, this can be a team effort. Many school teachers, coaches, and other friends are great resources when working through anxiety with kids.
Disclaimer: This post is not intended to provide therapeutic services. Please seek the help of a licensed professional for diagnostic assessment and help for treating anxiety disorders.