Anxiety Disorder

Anxiety and Depression in Children

Many children battle worry and fear. The also may feel sad and hopeless from time to time. Intense fears may appear at different times during development. For example, toddlers are often very distressed about being away from their parents, even if they are safe and cared for. Although fears and worries are typical in children, persistent or extreme forms of fear and sadness could be due to anxiety or depression. Because the symptoms primarily involve thoughts and feelings, they are called internalizing disorders.

Anxiety

Sometimes a child does not outgrow the fears and worries that are typical in young children. An individual may present with so many fears and worries that they interfere with school, home, or play activities. In these cases, the child may be diagnosed with an anxiety disorder. Examples of different types of anxiety disorders include:

  • Fearful when away from parents (separation anxiety)
  • Having extreme fear about a specific thing or situation, such as dogs, insects, or going to the doctor (phobias)
  • Being very afraid of school and other places where there are people (social anxiety)
  • Being very worried about the future and about bad things happening (general anxiety)
  • Having repeated episodes of sudden, unexpected, intense fear that present with symptoms such as heart palpitations, having trouble breathing, or feeling dizzy, shaky, or sweaty (panic disorder)

Anxiety symptoms such as fear or worry can also make children irritable and angry. Symptoms can also cause sleep disturbances such as sleeping too little or sleeping too much. Physical symptoms like fatigue, headaches, or stomachaches are common. Some anxious children keep their worries to themselves and, thus, the symptoms can be missed.

Depression

Occasionally feeling sad or hopeless is a part of every child’s life. However, some children feel sad or uninterested in things that they used to enjoy or feel hopeless or despair in many situations. When children feel persistent sadness and hopelessness, they may be diagnosed with depression.

Behaviors often seen in children with depression include:

  • Feeling sad, hopeless, or irritable a lot of the time
  • Lack of interest in activities they used to enjoy
  • Showing changes in eating patterns – eating a lot more or a lot less than usual
  • Showing changes in sleep patterns – sleeping a lot more or a lot less than normal
  • Showing changes in energy – being tired and sluggish or tense and restless a lot of the time
  • Having difficulty focusing on tasks or conversations
  • Feeling worthless, useless, or guilty
  • Showing self-injury and self-destructive behavior

Extreme depression can lead a child to think about suicide or plan for suicide. For youth ages 10-24 years, suicide is among the leading causes of death. Read about youth suicide prevention.external icon

Some children may not talk about their helpless and hopeless thoughts, and may not appear sad. Often, children who struggle with depression are labeled as trouble-makers or lazy as symptoms may present in destructive ways.

Treatment for anxiety and depression

The first step to treatment is to talk with a healthcare provider such as your child’s primary care provider or mental health professional about obtaining an evaluation. The American Academy of Child and Adolescent Psychiatry (AACAP) recommends that healthcare providers routinely screen children for behavioral and mental health concerns. pdf icon[217 KB, 13 pages]external icon Some of the signs and symptoms of anxiety or depression in children could be caused by other conditions, such as trauma. Specific symptoms like having a hard time focusing could be a sign of attention-deficit/hyperactivity disorder (ADHD). It is important to get a careful evaluation to get the best diagnosis and treatment. Consultation with a mental health provider can help determine if medication should be part of the treatment. A mental health professional can develop a treatment plan that works best for the child and family. Behavior therapy includes child therapy, family therapy, or a combination of both. The school can also be included in the treatment plan. For very young children, involving parents in treatment is key. Cognitive-behavioral therapy is one form of therapy that is used to treat anxiety or depression, particularly in older children. It helps the child change negative thoughts into more positive, effective ways of thinking, leading to more effective behavior. Behavior therapy for anxiety may involve helping children cope with and manage anxiety symptoms while gradually exposing them to their fears.

Managing Symptoms: Staying Healthy

Being healthy is important for all children and can be especially important for children with depression or anxiety. In addition to getting the proper treatment, leading a healthy lifestyle can play a role in managing symptoms of depression or anxiety. Here are some healthy behaviors that may help:

Prevention of anxiety and depression

It is not known exactly why some children develop anxiety or depression. Many factors may play a role, including biology and temperament. But it is also known that some children are more likely to develop anxiety or depression when they experience trauma or stress, when they are maltreated, when they are bullied or rejected by other children, or when their own parents have anxiety or depression.

Although these factors appear to increase the risk for anxiety or depression, there are ways to decrease the chance that children experience them. Learn about public health approaches to prevent these risks:

Schedule an Appointment