Anxiety Disorders in Children

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Normal Anxiety

All children and teens have some anxiety. But worries and fears that persist and prevent a child from participating in normal activities may signal the presence of an anxiety disorder. 

Anxiety disorders in children can occur due to a number of causes, including genetics, traumatic events, inherited or learned behaviors or chemical imbalances.

The Signs of a Mental Illness

Young children often can’t explain their feelings in words. Older children may resist expressing their emotions. Anxiety disorders often make themselves known through behaviors or physical symptoms. These include:

  • Frequent stomachaches or headaches
  • Muscle aches or tension
  • Sleep problems
  • Weight loss or gain
  • Extreme tiredness (fatigue)
  • Lack of concentration
  • Being easily startled
  • Irritability, tantrums, angry outbursts
  • Inability to relax

Common Types of Pediatric Anxiety Disorders

Generalized Anxiety Disorder (GAD)

A child with GAD has extreme worry and fear more intense than seems appropriate. Worries of this kind often focus on social acceptance, school performance, future events, etc.

Panic Disorder

A child with frequent panic attacks may have a panic disorder. Unpredictable and unexpected, panic attack episodes bring on feelings of great fear or discomfort that result in:

  • Shortness of breath
  • Dizziness
  • Lightheadedness
  • Shaking
  • Fear of losing control
  • A racing heartbeat

Symptoms can last for hours. But they often peak after 10 minutes.

Social Anxiety Disorder

A child with a social anxiety disorder experiences intense fear about one or more social or performance situations with others of the same age group, like acting in a school play or giving a speech in front of the class.

Separation Anxiety Disorder (SAD)

Severe fear and worry about being apart from family members or other loved ones that lasts for over 4 weeks, SAD usually appears around third or fourth grade.

A child may exhibit SAD both emotionally and physically, by:

  • Refusing to sleep alone, go to school, be alone
  • Being clingy
  • Panicking or erupting into tantrums when separating from caregivers
  • Worrying too much about losing a family member, getting lost, etc.
  • Having nightmares about separation
  • Experiencing frequent stomachaches, headaches, pain, muscle aches

Obsessive Compulsive Disorder (OCD)

A child with OCD has obsessive, unwanted thoughts coupled with compulsive behaviors that disrupt and interfere with daily activities and relationships. Thoughts commonly focus on dirt, germs, fears, self-doubt, or preoccupation with order. Common repeated behaviors include handwashing (100 or more times daily), checking locked doors, hoarding things, counting and recounting and following firm rules of order.


Common objects or situations about which children become phobic include animals, insects, blood, heights or open spaces. Extreme fear can cause a child to avoid normal activities.

Treating Anxiety in Children

Children and teens with anxiety can’t just pull themselves together to get better, nor will they grow out of it. Untreated, pediatric anxiety disorders can worsen or become a long-term problem.

The type of treatment your child needs depends on the symptoms present and their severity as well as your child’s age and general health.

Child psychiatrists at UVA can help you and your family find the treatment that will work best for your child.

Cognitive Behavioral Therapy (CBT)

Cognitive techniques help children think rationally about their anxiety in order to identify, understand and reduce worries and fears. Behavioral techniques guide the child in limiting or changing behaviors, finding better ways to handle anxiety.

Family Therapy

Parents and caregivers play a vital role in any treatment.


Your child may benefit from:

  • Antidepressant or antianxiety medicines
  • Selective serotonin reuptake inhibitors (SSRIs) (help raise levels of serotonin in the brain)
  • Antibiotics for OCD, if linked to a streptococcal infection

Stress management techniques can enhance treatment and include:

  • Regular physical activity
  • Meditation
  • Adequate amounts of sleep
  • Healthy food