Is My Kid OK? Kids and Anxiety


Q. I have a 6-year-old son who recently started kindergarten, and he worries all the time about his schoolwork and making friends. Is this anxiety normal?

A. At different ages and levels of development, it is appropriate for children to have a certain level of anxiety. It is commonly expected for children around 18 months to begin having stranger anxiety. Also, a certain level of separation anxiety occurs when kindergarteners begin school. Children may have a specific phobia (fear of something), whether it is regarding bugs, snakes or clowns. However, if the anxiety becomes so extreme that is keeps the child from developing a normal childhood and interferes with activities of daily living, parents may consider pursuing treatment. There are several anxiety disorders that can be diagnosed in children; usually age 3 is the earliest these can be diagnosed:

Generalized Anxiety Disorder is the most common anxiety disorder seen in children. Children are constant worriers. They don't sleep well and may be scared of the dark or have frequent nightmares. They may overthink situations and live somewhat in their head. They also may stress more over school that the average child. The child may be irritable and easily frustrated. Younger children, unable to verbally express emotions, may express them physically through temper tantrums.

Obsessive-Compulsive Disorder is another disorder that can occur. Children get recurrent invasive thoughts in their head, and the only way they can make them stop is to perform a ritual that makes the thoughts ease up. Pulling hair from scalp or eyebrows is a form of this.

Separation Anxiety Disorder is also common. Children will have a feeling that harm will happen to parents and/or siblings if they are not with them. They will have a hard time with separation whether it be to go to school or go to sleep. They will not want to be left alone. Some kids have nightmares that family members are injured or die.

Post Traumatic Stress Disorder can occur after a traumatic event. The child relives the event in their head and may avoid situations that remind them of it. Nightmares can occur too. Young children may re-create the event through play.

Children, like adults, can have panic attacks. These are episodes that last 15-20 minutes. They can be brought on by a specific stressor or simply by the fear of having one. Symptoms can include flushing, a racing heart and shortness of breath.

Therapy may be extremely helpful for issues with anxiety. Sometimes younger children have a hard time identifying feelings of stress and unease. The child can learn not only how to identify these symptoms but also learn ways to manage them. Children can learn deep breathing skills by blowing bubbles. Depending on the age, other methods can be incorporated. Younger children may use play therapy to act out stressors or re-create previous stressful events. Older children, who are able to express their feelings better, may benefit from more of a "talk" therapy.

There are also several medications that can help children deal with anxiety. Usually anti-depressants can help with anxiety and are not addictive. Talk to your primary-care physician, or request a referral to a mental-health provider.

Maripat Moore, MD, works for Moses Cone Behavioral Health in Kernersville. Please submit your questions to "Is My Kid OK?" by e-mailing

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