Anxiety and fears

• Anxiety: ages and stages
• Ways to support your child
• Types of child anxiety
• When to be concerned
• Finding professional help and treatment

Anxiety: ages and stages

In most cases, fears in childhood are fairly transient and short-lived. Different anxieties develop at different stages:

• Babies and toddlers might fear loud noises, heights, strangers and separation.
• Preschoolers might start to show fears of being on their own and of the dark.
• School-age children might be afraid of supernatural things (like ghosts), social situations, failure, criticism or tests, and physical harm or threat.

Infants and young children don’t tend to worry about things. For children to be worried, they have to imagine the future and bad things that might happen in it – this is why worries become more common in children over eight years of age.

Children also worry about different things as they get older. In childhood, they might worry about getting sick or hurt. In older childhood and adolescence, the focus becomes less concrete – for example, they may think a lot about war, economic and political fears, family relationships and so on.

What causes anxiety?
Some people are more likely to be anxious because it runs in the family (just like eye colour). People can also learn to think and behave in an anxious way by watching others, or by going through scary experiences. Certain things in a child’s environment might also increase the child’s chances of becoming anxious – for example, if a parent is overprotective of a shy child it might help the child in the short term, but can increase the child’s anxiety overall.

Ways to support your child

If your child displays signs of anxiety, you can support him in several ways:

• acknowledge your child’s fear – don’t dismiss or ignore it
• gently encourage your child to do things she’s anxious about, but don’t push her to face situations she doesn’t want to face
• wait until your child actually gets anxious before you step in to help
• praise your child for doing something he’s anxious about, rather than criticising him for being afraid
• avoid labelling your child as ‘shy’ or ‘anxious’.

Types of child anxiety

Children experience several types of anxiety. A child might have only one type of anxiety, or she might show features of several of them.

Social anxiety
Social anxiety is fear and worry in situations where children have to interact with other people, or be the focus of attention. Children with social anxiety typically:

• believe that others will think badly of or laugh at them
• are shy or withdrawn
• have difficulty meeting other children or joining in groups
• have a limited number of friends
• avoid social situations where they might be the focus of attention or stand out from others – for example, talking on the telephone and asking or answering questions in class.

Read our article on social anxiety for more information and tips on helping your child overcome this issue.

Separation anxiety
Separation anxiety is the fear and worry children experience when they can’t be with their parents or guardians. Children with separation anxiety typically:

• protest, cry or struggle when being separated from mum or dad
• worry about getting hurt or having an accident (they might worry about their parents or themselves)
• refuse to go to or stay at day care, preschool or school by themselves
• refuse to sleep at other people’s homes without their parents there too
• complain of feeling sick when separated.

Read our article on separation anxiety for more information and tips on helping your child overcome this issue.

Generalised anxiety
Children with generalised anxiety tend to worry about many areas of life – anything from friends at playgroup to world events. Children with generalised anxiety typically:

• worry about a variety of things – for example, health, schoolwork, school or sporting achievements, money, safety, world events and so on
• feel the need to get everything perfect
• feel scared of asking or answering questions in class
• find it hard to perform in tests
• are afraid of new or unfamiliar situations
• seek constant reassurance
• complain about feeling sick when worried.

Read our article on generalised anxiety for more information and tips on helping your child overcome this issue.

When to be concerned

Most children have fears or worries of some kind. If you’re concerned about your child, the following tips might help you decide whether you need to seek professional help.

• Ask yourself the following question: Is my child’s anxiety stopping him from doing things he wants to do? Is it interfering with his friendships, schoolwork or family life? If the answer is ‘yes’, consider seeking professional help.
• Compare your child’s behaviour with other children of the same age. For example, it’s common for most children to experience separation fears when going to preschool or school for the first time, but far less common over the age of eight. If your child’s behaviour is very different from that of other children, consider professional help.
• Consider how severe your child’s reaction is. If she’s extremely distressed and hard to settle when you leave her, for example, think seriously about professional help.

Severe anxiety can impact on children’s health and happiness. Some anxious children will grow out of their fears, but others will continue to have trouble with anxiety unless they receive professional help.

Finding professional help and treatment

You can seek professional information and advice from several sources:

• your child’s school counsellor
• your child’s GP or paediatrician (who might refer you to a child psychologist)
• your local children’s health or community health centre
• a specialist anxiety clinic (present in most states).

Treatment
The first step for children with severe anxiety is usually treatment that focuses on their behaviour in situations that make them anxious.

Cognitive behavioural treatment helps children develop skills that change their thinking in anxious situations, and increases their ability to cope by themselves. This therapy involves gradually exposing children to things they’re anxious about so they can learn to manage their feelings. This approach has long-term benefits for the treatment of anxiety.

Medications are sometimes prescribed for children with severe anxiety. Although this isn’t common, medications can help children when used in combination with cognitive behavioural treatment.

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