Children can suffer from anxiety. However, most children are not able to articulate what is troubling them or what they are worried/fearful about. The following are 14 things to look for to see if your child has anxiety (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000):
- Disruptive or agitated behaviour
- Repetitive play
- Crying, tantrums, freezing, clinging
- Difficulty separating from caretaker
- Sleep disturbance
- Difficulty concentrating
- Stomachaches and headaches
- Nausea and vomiting
- School refusal
- Failure to speak in specific situations
- Repetitive movements/behaviors
- Social anxiety due to a medical or mental condition
Children may respond to traumatic events or fearful situations with disruptive behavior or agitation. Again, children have difficulty articulating and expressing their emotions, so instead of talking it out, they act it out through agitation and disruptive behavior.
Children who have been exposed to trauma may replay the events through repetitive play. The nature of the trauma may be expressed through the play. Therapists utilize play therapy for both diagnostic and therapeutic purposes. Play with dolls and other objects may be telling. Also, drawings can inform the content of previous (or current) trauma.
Distressing dreams about a traumatic event may occur, but young children may not be able to articulate the specific content of their dreams. Children may have frequent visits to their caregiver’s bedroom or may have difficulty sleeping alone, due to the distress the nightmares bring.
When exposed to fearful situations, children may cry, exhibit tantrums, freeze, or cling to their caregiver. Again, young children have difficulty expressing and articulating their emotions, so they resort to primitive responses like crying and tantrums.
Children who have problems separating from their caretaker may have separation anxiety disorder. Children with separation anxiety disorder may have fears that their caregiver will be harmed when they are away from them. They may become irritable or lash out physically when forced to separate from their caregiver. When the caregiver finally leaves, the child may be so distraught that they disrupt the environment that they are in until the caregiver reunites with the child.
Sleep can be disturbed when a child is stressed and experiencing anxiety. The child may have restless sleep, requiring constant assurance from their caregiver.
Focus can be affected when a child is anxious. They become so fearful that they become distracted and are unable to complete tasks. They seem to exhibit disorganized behaviors.
Anxiety about defecating in specific places or general anxiety may lead to constipation or passing of feces into clothing or the floor. Transitions and change in structure can stress a young child, and some children may exhibit encopresis as an expression of that stress and anxiety.
When a child complains of a bellyache or headache, they may be manifesting stress and anxiety that is difficult to put into words. But anxiety needs an outlet, and the body gives a telltale sign via somatic complaints.
Nausea and vomiting may be a manifestation of anxiety in a child. Appetite may also be affected. Since nausea and vomiting are non-specific symptoms, one should also look for other symptoms of anxiety.
Refusing to go to school may be an indication of separation anxiety disorder or social phobia. Children may be fearful of separating from their caregiver, or they may have anxiety of social situations at school. Another reason may be that the child is being bullied at school, and may experience the bullying as traumatic.
Children who do not speak in certain situations, like at school or outside the home, may exhibit anxiety. More specifically, they may be exhibiting selective mutism. But children with selective mutism do have the ability to speak. For example, the child speaks well with close family members, but outside that close-knit circle, the child becomes mute.
Repetitive movements or behaviors may be indicative of compulsions, as seen in obsessive compulsive disorder. The compulsions may take the form of checking, counting, rearranging, or reordering rituals, just to name a few.
Children may have anxiety in social situations due to medical or mental conditions which may arouse negative attention from peers. Children can be ruthlessly honest and cruel when a peer has a medical or mental illness that singles them out. Examples of medical/mental illnesses which may arouse social anxiety include stuttering, mental retardation, autism, dermatological conditions, and anorexia nervosa.
In summary, children also experience anxiety, just like adults. However, unlike adults, children are not able to articulate their fears and worries. This list provides 14 things to look for to see if your child has anxiety. If your child has any of these symptoms, a referral to a child psychologist or child psychiatrist may be needed.