Anxiety: Signs and symptoms

Learn about the signs and symptoms of anxiety in children and teens.

Key points

• The physical symptoms of anxiety include stomach aches, nausea, muscle tension, and sweatiness.
• Behavioral symptoms of anxiety in children include difficulty falling or staying asleep, refusal to go to school, difficulty separating from you, and meeting new people. Teens can experience anxiety through excessive worries about school and fears of being judged by their peers when out in public.
• Your child’s doctor can diagnose anxiety by talking with you and your child and asking about their symptoms, daily life, and development.
• If your child is diagnosed with an anxiety disorder, your doctor may recommend therapy, medications, or lifestyle changes to help your child.
  

1- Introduction

What are the main symptoms of anxiety in children?

The main symptoms of anxiety can be grouped under physical symptoms and behavioral symptoms.

2- Signs and symptoms

A- Physical symptoms of anxiety in children

If your child is experiencing anxiety, they might complain of physical symptoms such as:

• stomach aches
• naughty
• difficulty breathing
• a faster heartbeat
• muscle tension
• sweatiness
• shakiness
• dizziness
• Frequent urination (peeing), especially before leaving the home
• headaches

You may also notice these symptoms in your child without their saying anything.

B- Behavioral symptoms of anxiety in children

Some behavioral changes that you might notice in your child include:

• increased irritability
• Difficulties falling or staying asleep unless, for instance, you sleep in the same room
• separating from you
• refusal to go to school or do other activities, even fun activities
• difficulties meeting new people
• not speaking to people outside of the family
  

How children express anxiety

Children who develop an anxiety disorder tend to express certain worries, including concerns that something bad might happen to them or their parent or caregiver or fears about embarrassment, natural disasters, animals, and so on. Children may even say they are worried about the future, relationships with others their age, and their school performance. These worries are usually so strong that they interfere with a child’s everyday activities.

Many younger children may not be able to communicate their anxiety verbally. Instead, they may show it through their behavior and physical symptoms.

C- Physical and behavioral symptoms of anxiety in teenagers

The physical symptoms of anxiety are similar for teenagers and children.

There are some differences in the behavior symptoms of anxiety in teens. Anxious teens may show fewer behavioral symptoms of anxiety in the home but have more difficulties outside. For instance, they might be able to sleep in a room on their own but have more trouble the home and may refuse to attend a school or take part in other social activities.

Typically, teens are more aware of their worrying thoughts and express them more clearly than younger children. An anxious teen is likely to express excessive worries about school, their marks, and their relationships. They may also be sensitive to issues in the news.

Socially anxious teens typically may express worries about being judged by others their age and may feel uncomfortable being out in public. They may also feel embarrassed about eating in public or using public bathrooms.

These would need to interfere with the teen’s everyday life before an anxiety disorder could be considered.

3- Diagnosis

How anxiety is diagnosed?

If you have concerns that your child’s anxiety is interfering with their daily life, see your child’s family doctor or pediatrician. They will talk with you and your child about:

• your concerns and the symptoms that are interfering with your child’s everyday routine
• any current stressors in your child’s life
• Any event or situation that might have triggered the anxiety symptoms
• your child’s development (from pregnancy onwards)
• Your family’s mental health history
• any family stressors
• the status of family relationships.

The doctor might ask you and your child, if they are old enough, to answer different questions, or fill out rating scales, to help them make a diagnosis. If the doctor identifies a number of signs and symptoms over a certain time (between one month to at least six months, depending on the anxiety disorder), your child may meet the criteria for an anxiety disorder.

Sometimes your child’s doctor may refer you and your child to a psychiatrist for help with the diagnosis.

4- Treatment

What your child’s doctor can do for anxiety

If your child is diagnosed with an anxiety disorder, you and your child’s doctor will decide on the best treatment. This decision may need input from other members of your family or your child’s teachers.

Your doctor may also suggest that your child sees a therapist or psychiatrist or recommend medications​ or lifestyle changes to help your child. Without treatment, anxiety disorders usually do not improve. In fact, they can often become worse over time.