When to Worry About an Anxious Child

Kids worry. Whether it’s fear of the dark, starting at a new school, or getting another pimple, children can take life very seriously. But some kids worry more than others. It’s always painful to watch a child suffer anxiety, but it’s especially difficult if you’re not sure whether she’s worrying too much and might need help.

The difference between normal worry and anxiety disorders is the severity of the anxiety. While feeling anxious is a natural reaction to stressful situations, anxiety becomes a disorder when it interferes with a child’s ability to handle everyday situations, or prompts her to avoid things that most people her age enjoy. Here are some guidelines for distinguishing an anxiety disorder from ordinary anxiety.

• Severe anxiety is unrealistic.
  After having sex a girl might worry that she has become pregnant. A girl with obsessive-compulsive disorder might worry that she is pregnant even though she’s never had sex.
• Severe anxiety is out of proportion.
  A high school sophomore might stress over taking the SAT. A boy with generalized anxiety disorder might stay awake at night worrying about the same test—even though he’s only in third grade.
• Severe anxiety is being overly self-conscious.
  A boy might feel nervous about talking to the girls in his class. Someone with social anxiety disorder might avoid ordering in a restaurant because he’s afraid of humiliating himself.
• Severe anxiety is often unwanted and uncontrollable.
  A kindergartener might cry at school because he misses his mother. A boy with separation anxiety might cry at school because he can’t stop thinking that his mother will die if he is away from her.
• Severe anxiety doesn’t go away.
  While anxiety symptoms are common and even expected after a disturbing experience, over time most children bounce back from them. Three months later a girl with post-traumatic stress disorder will still be having nightmares.
• Severe anxiety leads to avoidance.
  A girl might be nervous about going to a birthday party. A girl with a specific phobia of loud noises might refuse to go to birthday parties at all because she’s afraid that a balloon might pop.

The common theme with all of these disorders, which are estimated to affect 13% of American children and adolescents in a given year, is that they make children’s lives much harder than they should be and limit the experiences they are able to have. The good news is that behavioral therapy, sometimes combined with medication, is very successful in helping kids overcome their anxieties.