Children, Youth, and Anxiety

Anxiety is a normal and expected response to a threat. It’s what helps you notice danger and keeps you safe until a threat passes. Threats are not just about physical safety. Threats can include conflict at home, deadlines or expectations at school, or fitting in with social groups.

Some anxiety is necessary, even helpful. It’s what motivates people to take action or work hard to meet a goal. However, too much anxiety or anxiety that feels out of control can take a toll on health and well-being.

Anxiety is the most common mental health problem in young people. About 3% of Canadian children or youth experience an anxiety disorder. Yet anxiety may be dismissed in young people because they are still learning about the world and are naturally a little more anxious than most adults. Even if the worries or fears seem small from an adult perspective, those feelings are very real for the young person.

When is Anxiety a Problem?

Anxiety might be a problem when it is stronger than you’d expect, lasts much longer than you’d expect, or comes up often or feels out of control. It can cause problems with sleep or appetite, disrupt schoolwork or learning, and create other challenges. These anxiety problems show that someone might need help learning to cope with anxiety. Unhelpful anxiety can be harmful even when it doesn’t meet the criteria of an anxiety disorder, so any young person who experiences unhelpful anxiety may see the benefits of mental health help and support.

What is an Anxiety Disorder?

Anxiety disorders are a group of mental illnesses involving excessive anxiety. Anxiety disorders
can be very difficult, yet they aren’t always taken seriously. Anxiety problems that start in childhood may get worse over time. Even when anxiety problems appear to clear up on their own, people who experienced anxiety problems in childhood are more likely to experience an anxiety disorder later in life. Early treatment and support not only help children and teens get back to their usual lives, they build resiliency and teach skills that can last a lifetime.

Here are anxiety disorders that young people may experience:

• Generalized anxiety disorder—Excessive worry that comes up often and is difficult to control.

• Panic disorder—Recurring panic attacks and fears about having more panic attacks. (A panic attack is a period of sudden, intense fear that peaks quickly.)
• Agoraphobia—An intense fear of having a panic attack outside the home and being unable to leave or escape, leading to avoidance of spaces like school, public transportation, or large crowds.
• Phobias—Intense and unrealistic fears of a specific object, situation, or event.
• Social phobia or social anxiety disorder—An intense fear of social situations.
• Separation anxiety disorder—Extreme anxiety when separated or expecting to be separated from parents or caregivers.
• Selective mutism—Consistently refusing to speak in specific situations.

Common Signs of Anxiety Problems

• Refusing to go to school, participate in other activities, or see friends
• Difficulties at school, like problems concentrating or speaking in class
• Becoming very upset when parents or caregivers leave
• Often seeking reassurance that everything will be okay
• Avoiding specific things, like dogs, or situations, like large crowds
• Becoming very upset over minor problems or conflicts
• Expressing a lot of concerns or asking a lot of “What if…?” questions
• Difficulties sleeping well or eating well
• Physical complaints like stomach aches, headaches, shakiness, or dizziness
• Having panic attacks more than occasionally

Some of these signs are not unique to anxiety disorders. If you notice these signs, it’s a good idea to seek help from your doctor or a mental health professional.

What Can I do About It?

If you’re concerned about a young person, you can find help and support from:

Your family doctor—Family doctors are often the first place to seek help. They can also refer the young person and their family to more specialized mental health care, if needed.

A young person’s school—Schools can help young people succeed in their education. School counsellors can offer support, advice, and referrals to community resources. Some schools even offer anxiety programs, courses, or therapies.

The good news is that anxiety problems and anxiety disorders are very treatable. The goal is not to avoid all anxiety. The goal is to learn how to manage unhelpful anxiety and cope well with normal anxiety. Here are common approaches for young people:

• Self-help strategies—Self-help strategies can assist young people to build healthy routines and coping skills. This might include simple daily tasks like eating well, getting enough physical activity, taking time to relax, and building a healthy sleep routine.
• Therapy approaches—Therapies like cognitive- behavioural therapy or CBT can be a very effective way to treat and manage anxiety problems. In CBT, young people and families learn how to identify thoughts and behaviours that drive unhelpful anxiety, look at problems or situations more realistically, and begin facing feared situations using different coping skills.
• Parent and family education—When a young person experiences a problem with anxiety or an anxiety disorder, the entire family may be affected. Parent and family education teaches parents, caregivers and other family members how to respond to anxiety problems, use healthy coping behaviours at home, establish limits when anxiety behaviours cause problems, and other strategies to help everyone at home feel well.
• Medications—In some situations, medications may help. However, these may not be appropriate for all ages. Talk to your doctor to learn more.