Anxiety disorder in children

Children's normal anxiety should be distinguished from anxiety disorders where anxiety appears unfounded.

Anxiety disorder in children


Boy looks anxiously under the bed

Children and anxiety belong together in a natural way. Because children are discovering the world. And there is a lot of news that children can sometimes scare. In addition, children have a lively imagination. Parents know that occasionally you have to drive a monster out of the closet or keep watch, so that the "black man" does not disturb the child's sleep. To differentiate these childish normal fears are anxiety disorders in children, as they increasingly diagnose child psychologists and paediatricians.

Identifying the signs of anxiety disorders in children is by no means easy. Children do not grasp fears rationally with their minds and often can not control or verbalize their pain. Thus, their specific fears often remain hidden or only come to light through detours or through certain symptoms. Children do not always talk about their fears, but they talk about behavioral problems.

Often, children and adolescents have generalized anxiety disorders, sometimes the fears relate only to specific situations (prior to class work or contact with specific animals). Generalized anxiety manifests itself, for example, in exaggerated worries about everyday events, excessive delusions of separation (often at kindergarten and school visits) or the fear of embarrassing others. Often the children try to avoid the anxiety-provoking situation. As a result, the school performance often worsen, living together in the family is increasingly difficult, friendships diverging and sometimes the contact with peers is missing completely.


Children's anxiety disorders are now among the most common childhood and adolescent psychiatric disorders. It is estimated that 10 to 15 percent of children and adolescents are affected.


The symptoms of anxiety disorders in children are very diverse. Ultimately, the full range of vivacious or nervous child behavior can also point to an anxiety disorder. However, these symptoms do not provide sufficient assurance of a diagnosis. Especially striking symptoms of anxiety disorders in children are:

  • decreasing curiosity
  • Regression (abandonment of acquired skills such as language or cleanliness)
  • Wetting and buying
  • self-selected insulation
  • Passivity or hyperactivity
  • selfharming behaviour
  • Rip hair or tear hair (trichotillomania)
  • compulsive behaviors
  • Tremble
  • difficulty in breathing
  • Stutter.

Basically, two behavioral changes are considered important alerts: when a child falls silent or becomes very aggressive. And to an extent that is untypical for the respective development phase.

Sensitive children are more likely to suffer from anxiety disorders

Both girls and boys are afraid, only the symptoms are different. While boys often become violent, girls retire to their shell. Many starve to death or hurt themselves.

Anxiety disorders mainly occur in sensitive, shy and reserved children and adolescents. They are quickly irritated by changed everyday situations and react in new environments rather fearfully. Children and adolescents with anxiety disorders usually dare very little and have difficulty coping with actually manageable difficulties.

Recognize pathological anxiety in children

In anxiety disorders children show anxiety in certain situations, which seems unfounded to outsiders. Typical are refusal postures and disease symptoms. Some examples:

The child

  • refuses to go to kindergarten or to school
  • Do not play alone outside
  • Do not want to fall asleep alone in the evening
  • does not stay home alone for a short time during the day
  • do not want to stay with friends
  • cries and screams or beats around and clings to the mother (or confidant) when saying goodbye โ€ข often has headache and abdominal pain
  • suffers from insomnia and tiredness, muscle tension or dizziness.


The causes of anxiety disorders in children are usually in the family environment. Risk factors for the occurrence of anxiety disorders in children are an unfavorable family climate and a low socioeconomic status. Even in the first years of life, social and economic problems affect the health of children. Material poverty, social decline, conflictual and violent family relationships as well as an education-distant environment increase the risk of developing anxiety disorders and other mental health problems.

Familial misconduct does not always have to be the trigger for anxiety disorders in children.However, the lack of or understanding of the plight of a child with anxiety is a key factor in overcoming a fear or turning it into an anxiety disorder over time.

Furthermore, medical professionals assume a genetic predisposition to increase the risk of anxiety disorder.

Other causes of anxiety disorders in children and adolescents

An anxiety disorder in children and adolescents is often preceded by certain life experiences. These include in particular:

  • Separation of parents
  • serious illness of a parent
  • Death of a close person, especially a sibling
  • own serious illnesses (like acute leukemia or a serious accident)
  • temporary accommodation in homes or a foster family
  • threatening experiences (environmental disasters, apartment fires, avalanche spills and the like).


Childish behavior changes frequently. And not behind any timidity is an anxiety disorder. However, if you notice any noticeable cause of behavioral problems or a change in your child's behavior without a detectable cause, a consultation with the pediatrician can help. Also an educational counseling center or a psychologist are suitable contact persons for the diagnosis of an anxiety disorder in children.


The therapy of anxiety disorders in children belongs in the hands of an experienced psychiatric pediatrician or child therapist. Only those usually have the experience to assess whether a therapy of anxiety disorders in children at all is necessary. The course and duration of such therapy depend on the individual needs of the child. When choosing a suitable therapist, you should be very careful that the therapist takes your child seriously and the child feels comfortable there.

Behavior therapy as a remedy for anxiety

Fears in older children and adolescents are usually treated with cognitive-behavioral therapy. In order to avoid generalization and chronification, it should be started as soon as possible. The aim of the therapy is to change the behavior that causes anxiety-related thoughts and thus reduce anxiety. Suitable for this are certain behavioral exercises, role-playing games and relaxation training.

During cognitive behavioral therapy, the child / teenager recognizes which thoughts increase his anxiety. Then, the truth of the thoughts and the possible likelihood of the dreaded event occurring are checked. Together with the therapist new thoughts and strategies are developed, which help to better deal with the anxiety situation. There are also other important components of the therapy.


As a child's parent or adult contact, you can greatly help prevent anxiety and anxiety disorders in children. Fear arises - even in adults - primarily through the feeling of losing control of a situation. The best remedy for fear is to regain control. As a parent you can support your child and give him security.

Responding compassionately to childish fears

Many parents tend to respond to childlike fears in a conversational and rational way. This corresponds to the adult attitude. Children are not small adults. Thanks to their vivid imagination and lack of life experience, they are sometimes unable to distinguish a real threat from a supposed one. In addition, parental solutions are often taken up with resistance and blockade anyway. Successful anxiety processing is only possible if children are allowed to participate constructively and if they experience demand, support and empowerment.

Even though adults often regard the fears of children as harmless, they should always be taken seriously. For the child, the reasons for fears are always very real. The monster under the bed is just as scary as neighbor's dog.

Fear coping with imagination

Especially children have a powerful tool for successful anxiety management: play, magic and ritual. These very own processing options should be used.

  • Cope with fears in the game: children always play. They play with experiences or roles. After anxiety-inducing extraordinary experiences, it can very often be solution-oriented replay games that have the traumatic experience as their content. Playing helps to find solutions and supports the childish processing process.

The power of imagination

Children believe in the power of imagination and in their magic. With the child's logic, this means that the fantasy that brings forth monsters and robbers can make them disappear again. Use the power of childlike creativity by, for example, reading stories and fairy tales to the children or lending magical powers to the cuddly toys.

The magical-fantastic thinking of children (between the ages of 4 and 9) is an age-appropriate form of intelligence with which children are creative to understand their environment, their local and environmental environments.Magical thinking is a structuring attempt. Many of the developmental tasks of this time are traversed by fears. With magical-mystical thinking these fears can be better endured and coped with more productively.

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