Anxiety in children, teens, and young adults
Anxiety is a universal emotion, experienced by everyone to some degree. At its most basic, it’s a feeling of unease when we’re facing an event or experience with an uncertain outcome. Learning to manage anxiety — to bear this unease while figuring out if there is something we can do to change the outcome — is an essential part of growing up. In the right place, time, and amount, anxiety can even work for us — protecting us from harm, pushing us to take on new challenges, and helping us build knowledge, resilience, and self-confidence. But what’s a healthy level of anxiety and what’s not? That’s a question more families are struggling with, and with children of all ages. The difference between healthy anxiety and problematic anxiety can depend on:
- Age and stage of development
- How realistic and large the worries are
- How long the anxiety or worries lasts
- How much the anxieties interfere with your child’s or your family’s life
Learn more about anxiety at your child’s age
Anxiety in early childhood (0-5 years)
As babies and young children increasingly experience the world, fears are a normal part of their development. Infants and toddlers commonly fear separation from parents and other caregivers, being around strangers, and new and unknown surroundings and experiences. Preschoolers often have fears of real or imagined things, like ghosts, monsters, the potty, and the dark.
What can I do?
Some level of anxiety is important to help us learn and grow. Even at a very young age you can begin to teach your child to identify worries and work with them rather than accommodate or avoid them. Among the things you can do:
- Create a calm environment, starting by remaining calm yourself when your child is anxious
- Be curious and help your child to talk about their fears so they know it’s safe to share them with you. If your child tends to want to talk about their fears too often, set aside a small amount of time each day, such as 5 minutes after dinner
- Normalize anxiety — let your child know that everyone is anxious at times, even you
- Don’t accommodate or enable your child’s efforts to avoid things that make them anxious (unless you feel that they’re unsafe)
- Teach your child to “talk back” to worry by encouraging them to not let worry be a bully, and to ask for help
- Prepare your child for new experiences or situations by describing what to expect
When should I be concerned?
Reasons for concern arise when a child is worried about things not typical for their age/stage of development or their symptoms are so severe that they interfere with normal activities. In general, you should be concerned if your child’s anxiety:
- Seems out of proportion
- Takes up a lot of time and mental energy
- Leads to avoidance of situations
- Interferes with their ability to take part in developmentally appropriate activities, such as sports, play, or family activities
- Doesn’t decrease with time (or worsens)
- Causes extreme irritability
- Causes trouble sleeping
- Impacts appetite
- Causes unexplained physical issues, such as stomachaches, chest pains, or frequent trips to the bathroom
- Requires frequent trips to the doctor’s office without identifiable medical reasons
- Leads to reliance on rituals or superstitions that disrupt daily life or, when not followed, lead to extreme distress
Where can I get help?
- Talk to your child’s pediatrician about your experience and for guidance
- Contact Ohana at (831) OHANA01
If treatment is recommended, the focus is usually on supporting parents rather than directly addressing it with the child. Treating anxiety disorders in preschoolers requires consistent involvement and feedback from caregivers. Young children usually are unable to identify reasons for their behaviors or change specific patterns without support from loved ones. Your child’s therapist may ask you to create new routines, establish a behavior plan, ask your child to do new or challenging things, and praise their bravery when taking on their fears.
Ohana uses a range of treatments that are based on evidence and experience. We know that no two families are alike and choose the best options for you, after an assessment of your child and family. Learn more about our treatment approaches.
Anxiety in school-age children (6–11 years)
As children get older, their fears often grow broader and reflect real-life concerns. They may be anxious about schoolwork or exams, making friends, parents divorcing, natural disasters, or death. During this period, they’re facing new challenges every day in school, learning to develop friend groups, trying new activities, and spending more time outside the familiar family setting. There’s potential for anxiety in all of those situations — and the potential for growth if they can face their fears and learn from them.
What can I do?
To help your child manage their anxieties, you can:
- Encourage your child to talk about their fears so they know it’s safe to share them with you
- Help your child learn to identify feelings vs. facts and to develop skills to manage their feelings
- Help them focus on what they can control
- Don’t accommodate your child’s wish to avoid the things that make them anxious (unless they’re unsafe); encourage them to face their fears and take steps to overcome them
- Prepare your child for new experiences or situations
- Focus on effort over performance and discovery over achievement
When should I be concerned?
Reasons for concern arise when a child is worried about things not typical for their age or stage of development or that:
- Cause extreme distress
- Seem out of proportion to the situation
- Take up a lot of your child’s time and mental energy
- Lead to avoidance of situations
- Cause trouble sleeping
- Impact appetite
- Don’t go away with time
Where can I get help?
- Talk to your child’s doctor about your experience and for guidance and, if recommended, a referral to a mental health professional
- Talk to your child’s school about what they’re experiencing and for resources
- Contact Ohana at (831) OHANA01
Treatment for school-age children may be recommended after an assessment with a medical or mental health expert. If your child is diagnosed with an anxiety disorder, cognitive behavior therapy (CBT) and parent coaching are some of the best treatments available for children with anxiety. In CBT, children learn skills such as identifying their emotions and relaxation strategies like deep breathing or mindfulness so they can routinely deal with manageable amounts of fear or anxiety. Parents learn how to support and empower their children to tackle scary or hard situations.
Ohana uses a range of treatments that are based on evidence and experience. We know that no two families are alike and choose the best options for you, after an assessment of your child and family. Learn more about our treatment approaches.
Anxiety in teens (12–18 years)
The challenges, experiences, and expectations that come with adolescence usually also come with increased insecurities. Teens are worried about social and romantic relationships and fitting in, how they compare to others, and feeling increased pressures about school and their futures. They’re also more aware of what’s happening in the larger world around them, which may feed broader anxieties about things like the environment, pandemics, or social issues.
What can I do?
To support your teen you can:
- Provide an open and supportive environment
- Listen and be curious
- Acknowledge how they feel with statements like, “I can understand how you might feel anxious about this”
- Help them focus on what they can control
- Think about what coping skills already work for them and how they can be used to manage anxiety
- Help them build problem-solving skills through coaching
- Provide structure for self-care: maintain rules about sleep, and support routines for exercise and good nutrition, and relaxation
- Model the behaviors and skills you want your teen to use
When should I be concerned?
Some teens are good at hiding their anxieties, and internalizing their fears. Some act out, lashing out at those around them. Others might withdraw, refusing to go to school or take part in activities. You should consider seeking professional help if your teen’s anxieties:
- Take up a lot of their time and mental energy
- Lead to distress out of proportion to the events at hand
- Lead to isolation and withdrawal
- Prevent them from being able to distinguish facts from feelings
- Disrupt sleep — getting too little or too much
- Impact appetite
- Keep them from doing tasks needed for independent living, such as:
- Making friends
- Advocating for themselves
- Dealing with others in every-day situations like ordering in restaurants or paying at the counter in a store
- Asking for help
Where can I get help?
- Talk to your child’s doctor about your experience and for guidance
- Check with your child’s school for resources they may have to support you and your child
- Contact Ohana at (831) OHANA01
If recommended, your teen may be evaluated to learn more about their anxiety and the causes, which will help determine the best treatment options. Cognitive behavioral therapy is one common way to treat anxiety. This therapy focuses on changing thoughts and emotions that can negatively affect behavior. The therapist helps the child become aware of their thoughts and feelings, and to understand the difference between feelings and facts. Changing unhelpful or negative thoughts can change the emotional reactions and behaviors that come with them. Medication may also be part of their treatment.
Ohana uses a range of treatments that are based on evidence and experience. We know that no two families are alike and choose the best options for you, after an assessment of your teen and family. Learn more about our treatment approaches.
Anxiety in young adults (19–25 years)
Young adults are faced with many new and anxiety-provoking situations, such as:
- Leaving home
- Taking on jobs and financial responsibility
- Managing their own money, schoolwork, and daily self-care without built-in parental support
- Developing more serious romantic relationships
Suddenly, perhaps with little preparation, they are expected to manage their life on their own. Young adults who have experienced anxiety throughout their lives often struggle even more with this transition. This increases the risk of failing to make the transition from home to independent living.
What can I do?
- Keep in contact and ask how they’re doing with their studies, work, friends, and other activities
- Talk openly about major life changes, what they involve, and worries and fears that might arise
- Let them know that it’s normal to feel anxious at times
When should I be concerned?
If your young adult is living with you or you are connected despite geographic distance, you should be concerned if anxiety:
- Takes up a lot of their time and mental energy
- Leads to distress out of proportion to the events at hand
- Leads to isolation and withdrawal
- Disrupts sleep or impacts appetite
- Keeps them from doing tasks needed for independent daily living
- Causes panic attacks, with symptoms such as a racing heart and difficulty breathing
Where can I get help?
If your young adult is having emotions and behaviors that are ongoing and affect their daily life and relationships, talk with them about seeking help right away. Once they are 18, you no longer have access to their medical information unless they give permission, but you can support them and suggest these paths for help:
- Talk with their primary care doctor
- If they are in college, seek university mental health services
- If they are working, connect with an employee assistance program (EAP), if one is available
- Contact Ohana at (831) OHANA01
An assessment by a mental health professional can help determine the causes of your young adult’s anxiety and identify treatments to help them. They may suffer from a general anxiety and stress or something more specific. Two primary treatments for anxiety are therapy and medication. Cognitive behavioral therapy is commonly used and focuses on changing thoughts and emotions that can negatively affect behavior. The therapist can help your young adult become aware of their thoughts and feelings, and to understand the difference between feelings and facts. Changing unhelpful or negative thoughts can change the emotional reactions and behaviors that come with them.
Ohana uses a range of treatments that are based on evidence and experience. We know that no two families are alike and choose the best options for you, after an assessment of your child and family. You can learn more about our treatment approaches here.
