Childhood Anxiety: Signs Your Child May Need Help

Dr. Scott Moseman, Child and Adolescent Psychiatrist, Laureate Psychiatric Clinic and Hospital, answers common questions about childhood anxiety.

Q: Is anxiety becoming more common in children?

A: I think modern parents do a better job at recognizing symptoms in kids and are more involved in understanding how it works. Anxiety is the most common mental health disorder that people seek care for through all stages of development into adulthood.

Anxiety is also genetically determined. Anxious, caring, smart parents have anxious, caring, smart kids. It’s good to be aware of what’s normal and what becomes something that needs treatment.

Q: How can parents tell the difference between normal anxiety and a problem that may need help?

A: Anxiety works on a curve. We need the right amount of anxiety. Not enough, and you don’t care how you impact others, you don’t get things done or show up to places on time. Too much, and you can’t perform, sleep or function.

The key is function. Kids should be able to play, go to school, have friends, sleep, eat and do the normal things that help them move forward. Anxiety becomes a problem when it significantly interferes with those things.

Q: What are some signs parents should watch for?

A: Being anxious about tests and grades or whether friends like them can be pretty normal. But watch for things like panic attacks, trouble sleeping, changes in eating, declining grades, isolation, school avoidance or a decline in sports or activities they enjoy.

When things they used to enjoy become difficult because they’re spending so much time worrying about or avoiding bad outcomes, that’s something to pay attention to.

Q: When should a parent consider seeking professional help?

A: I think there should be a relatively low threshold if you have a worry. A good professional, whether it’s a therapist or physician, can do a diagnostic evaluation and determine whether what a child is experiencing is developmentally appropriate or whether there is an anxiety issue that needs treatment.

Treatment doesn’t always mean medication. Therapy is usually a first course of care and works very well for a lot of kids. In more severe cases, or if there is a lack of progress in therapy, medication can be helpful as an adjunct to therapy.

Q: How do social media and screen time affect anxiety?

A: Research into the impact of screen time is difficult because so many things are affecting kids at the same time. Social media can lead to comparisons and social worries, and it can affect attention and patience.

There are also studies showing that the internet can help some lonely or isolated kids connect with like-minded people and feel less alone. Like any tool, it should be monitored and used in moderation. Parents can help determine how much and when, while making sure kids are sleeping and getting other things done.

Q: What if a child is reluctant to talk to a therapist?

A: The best child therapists are really good at connecting and listening to kids. That’s one of the most important things: Does the therapist listen, and does your child feel connected?

Sometimes it can be a matter of therapist fit, so trying a different therapist may be appropriate if something isn’t working. I’m pleasantly surprised that a lot of this generation likes and makes good use of therapy.

Q: What would you tell parents who feel hesitant about seeking help for their child?

A: Anxiety is not a weakness. I remind patients and families that anxiety is closely correlated with intelligence and empathy, things we all want our kids to have.

It’s also important to remember that untreated illness has side effects, too. Treatment is about finding a balance where we’re maximizing benefit while minimizing any ill effects. Parents still get to decide which path is best for their child, but it’s good to start by hearing the alternatives. There is no reason to suffer in silence. Treatment really can improve quality of life.