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Anxiety in Children and How to Provide the Support They Need


Hillary Mortenson, LMSW

Anxiety disorders can develop from a broad number of risk factors including genetics, brain chemistry, personality and life events. And in these uncertain times, it is common to struggle with an increase of anxiety, worry and fear as we manage our lives.

Persistent anxiety affects the thoughts and behavior of children as well, which interferes with their ability to live a healthy and balanced life. The goal is not to eliminate anxiety, but to help our children manage it.

It is natural for children to feel worried or anxious from time to time due to life events or increased expectations like starting school, public speaking or anticipating a homework assignment being due. However, the difference for some children is their anxiety, worry and fears are persistent and impact their daily living. According to The Journal of Pediatrics, “7.1 percent of children aged 3-17 years (approximately 4.4 million) have been diagnosed with anxiety.”

The prevalence of anxiety disorders has shown to increase as children get older and their expectations and life experiences become more intense and overwhelming. According to the National Institute of Mental Health, “Anxiety disorders affect 25.1 percent of children between ages 13 and 18 years old. Untreated anxiety disorders are at higher risk to perform poorly in school, miss out on important social experiences and engage in risky behaviors.”

Common symptoms of anxiety in children include difficulty sleeping and staying asleep, nightmares, poor appetite, difficulty concentrating, increased irritability or anger outburst, constant worry, negative thought patterns, stomach aches, crying spells, and chronic nervousness.

Anxiety disorders are treatable with professional help such as therapy and medication. However, we can help our struggling children at home, as parents with coping skills. These are tools and techniques to help manage mood, handle difficult emotions and maintain internal emotional order

While there are many coping skills to help manage anxiety, it is important to remember not all coping skills fit each person the same. While one person might find breathing techniques and counting to 10 to be helpful, someone else might not. Since coping skills are unique to an individual, they should be identified by the person struggling with anxiety.

In general, coping skills can be separated into two groups, problem-based coping and emotion-based coping. Problem-based coping skills help to solve a problem while emotion-based coping skills help to self-soothe when the root of the problem cannot be changed. For example, if a child does not want to go to school, inserting a mindfulness exercise as an emotion-based coping skill may be helpful since they must attend school. Other examples of helpful coping skills include deep breathing, positive affirmations, embracing the physical stress sensations, radical acceptance that this moment will pass and open communication with someone safe.

The biggest impact to successfully managing anxiety with coping skills is when a child should use it. Our bodies have a way of letting us know when we are reaching a place that needs to be managed with a coping mechanism. This is referred to as physical signs of stress and can include headaches, stomach aches, shortness of breath, tearfulness, shaky hands, tightness of the chest and increased heart rate.

Immediately identifying what our body tells us will inform an individual to act at the first signs of physical stress. This will better manage a person’s mood and de-escalate before spiraling out of control with obsessive thinking or panic.

One of the biggest issues with managing anxiety is avoiding or distracting yourself from the negative emotions. In reality, avoidance increases anxiety in the long run. Dodging what makes you anxious or the feelings you experience in an episode of high anxiety may work to soothe you in the moment, but the key to managing anxiety is recognizing that your feelings and emotions do not control you.

We need to train our brains to realize we are brave and capable even though the situation seems overwhelming. Children will be empowered to remember their anxiety cannot harm them and they are the boss of their bodies if they receive assistance from trusted loved ones to help train their brains.

Repetitive actions (like going to school when they don’t want to) will train their brains to remember they can do it and have survived 100 percent of those situations so far.

When a child learns difficult feelings and emotions can be felt without fear, they build a sense of confidence to experience unwanted emotions but remain in control over what happens next.

We all experience uncomfortable feelings of anxiety, worry and fear. But by reminding ourselves or our children that we can exist with these feelings — although uncomfortable and unwanted — we are safe, and this difficult moment will pass.

Hillary Mortenson, LMSW is a staff  therapist at Child and Family Solutions Center. She works with children, teens, adults and families  She can be reached at 248-851-5437 and