Unravelling Anxiety Disorders: The Six Types that Affect Children

There is a significant difference between normal anxiety and an anxiety disorder. All children experience anxiety. It is a natural and healthy part of growing up. However for some children anxiety becomes persistent, intense, and significantly disruptive to daily life. Understanding the difference matters enormously because anxiety disorders in children are both common and frequently missed.

According to NHS England’s Mental Health of Children and Young People report 2023, one in five children and young people aged eight to twenty five had a probable mental disorder. Mental Health of Children and Young People in England 2023 report, Anxiety disorders are among the most common and yet they often go undetected, sometimes for years.

Normal anxiety versus an anxiety disorder

Anxiety in response to new or challenging situations, starting school, taking a test, making new friends, is completely normal and usually short lived. It does not significantly interfere with daily life and can even help children develop resilience and coping skills.

An anxiety disorder is different. It is characterised by excessive fear, anxiety, or worry that is disproportionate to the situation, happens more often than not, and persists for at least six months. It significantly affects a child’s quality of life, their relationships, their learning, and their ability to function day to day.

You can read more about what is happening in your child’s nervous system when anxiety takes over in my free guide Understanding Your Child’s Guard Dog Brain.

Separation anxiety

Separation anxiety is a natural developmental stage in younger children. However some children experience separation anxiety that does not ease with age. It intensifies, persists, and begins to significantly interfere with daily life. Children may complain of tummy aches, headaches, or other physical symptoms. They may cling to parents, refuse to go to school, have nightmares with a theme of separation, or be reluctant to be alone even at bedtime.

It is worth knowing that separation anxiety is not limited to younger children. Teenagers experience it too, sometimes in ways that are harder to recognise. You can read more in my blog Even Teens Have Separation Anxiety.

Generalised Anxiety Disorder

Children with GAD worry about almost everything, and the worry is chronic, long lasting, and hard to control. Unlike other anxiety disorders, GAD focuses internally rather than on specific external triggers. Children with GAD tend to seek frequent reassurance from parents, teachers, and peers, although that reassurance only brings temporary relief.

You might notice constant what if questions. Will we get there on time? What if I cannot sleep the night before the test? What if something goes wrong? You may also notice negative thinking patterns, cognitive distortions, that are overly self-critical and unrealistic. Unlike adults, younger children cannot always recognise that their beliefs are unrealistic.

Panic disorder

Panic disorder typically starts in older children and young adults. It involves repeated, unexpected episodes of intense fear accompanied by physical symptoms such as feeling faint or dizzy, nausea, chest pain, shortness of breath, heart palpitations, hyperventilating, or fluctuating body temperature. The fear of having another panic attack can itself become a significant source of anxiety, leading to avoidance of situations where attacks have occurred before.

Specific phobia

A specific phobia is an extreme or unreasonable fear linked to a particular animal, object, activity, or situation. The fear causes significant distress and can prevent a child from participating in normal daily activities. In my practice I have worked with children and families dealing with fears of insects, rain, and dentists, among many others.

Social anxiety

Social anxiety involves persistent fear in social or performance situations where a child feels observed or evaluated by others. They may worry about behaving in a way that is shameful or humiliating. Consequently they may avoid social situations altogether or participate in them with extreme distress.

You might notice your child becoming very anxious when performing tasks in front of others, fearing making mistakes or being ridiculed, struggling with eating, talking, or participating in activities with other people, finding it difficult to ask or answer questions, read aloud, or give presentations at school. School can become a significant source of distress.

Selective mutism

Selective mutism is when a child consistently does not speak in situations where speaking is expected, most commonly at school. It is not a communication disorder and it is not shyness or a choice. Children with selective mutism can communicate confidently and fluently in environments where they feel completely safe and relaxed, typically at home with immediate family. In other settings the anxiety is so intense that speech becomes impossible.

Why do anxiety disorders develop?

The causes are complex and rarely come down to one single factor. According to the Association for Child and Adolescent Mental Health, genetics, temperament, family dynamics, and environmental factors all contribute.

Genetics play a significant role. Children of parents with an anxiety disorder are seven times more likely to develop one themselves. Temperament matters too, an inhibited or highly sensitive temperament in early childhood is a risk factor for anxiety disorders in later childhood and adolescence. Emotional neglect, criticism, a negative relationship with an attachment figure, stressful life events, and trauma can all contribute. Neurodiversity is also highly relevant. Children with ADHD and autism are significantly more likely to experience anxiety, and standard approaches do not always work well for them.

What helps

CBT is the most evidenced treatment for anxiety disorders in children and adolescents and can be delivered in different formats including parent guided sessions and individual therapy. However CBT is not suitable for everyone. For younger children, particularly those under eight, or those who are neurodivergent, play therapy, sand play, and art therapy are often more appropriate and equally effective.

The most important thing is to seek support early. Most young people with anxiety disorders do not access clinical services and consequently do not receive treatment, which can lead to academic and social difficulties that persist into adulthood.

When to seek support

If your child’s anxiety is significantly affecting their daily life, their relationships, or their ability to attend school, please do not wait. Your GP is the first point of contact. In the meantime I am here if you would like to talk it through.

Interested in working with me?

I work with children and young people with anxiety disorders using play therapy, talking therapy, and parent focused approaches. I also offer therapeutic support for parents and training and consultation for schools and professionals.

You can reach me via my contact page.

Free resources

Understanding Your Child’s Guard Dog Brain explains what is happening in your child’s nervous system when anxiety takes over.

Holding in the Storm is about staying steady as a parent in the hard moments.

When Darkness Comes for support with anxiety and sleep.

All free to download.