ANXIETY IN KIDS AND TEENS

We all have worries and stress in our lives. Anxiety in young children at specific times in development is normal. For example, between the ages of about 8 months to preschool years (4-5) healthy kids may show intense distress at times of separation from their parents or other people they are close to. Young children may have short-lived fears, such as fear of the dark, storms, animals, or a fear of strangers.  Worries, fears, and stress can become an anxiety disorder for children and teens when the fears interfere with their lives for more than four weeks. Children and teens might become more withdrawn, avoid certain activities- even resist going to school, be more irritable, have outbursts of crying or temper tantrums, and complain about feeling sick. Children and teens might be on edge, looking for perceived dangerous situations to avoid and consequently be tense and on guard.

How prevalent is anxiety in children and teens?

Data collected from 2021-2022 in Ohio determined that almost 12% of Ohio children, ages 3-17 had anxiety.¹ The Center for Disease Control (CDC) data from 2022-2023 found that an anxiety disorder was found in 2.3% of children ages 3-5, 9.2% of children 6-11, and 16% of children 12-17.²

What are the types of anxiety in children and teens?

Separation Anxiety Disorder: As referenced earlier, separation anxiety (not disorder) is a normal developmental phase. Separation Anxiety Disorder is extreme and continues beyond the typical developmental period. Kids may be worried about parents or other family members and have difficulty going to school or being away from home or may have difficulty falling asleep. If your child shows extreme distress with separations that is a sign to seek professional help.

Specific Phobias: Fear when in danger is good, fear helps us to survive. Specific phobias are extreme fears that are out of proportion with an actual threat of danger. A thunderstorm becomes a fear of a tornado, or any other circumstance that becomes catastrophized and blown out of proportion. For example, an intense fear of insects, a fear of elevators, escalators. Sometimes a child or teen will say “What if” this or that happens.

Social Anxiety: This is an intense fear of being judged or rejected in social situations. A child may avoid interacting with others at school or have a hard time speaking to people.

Generalized Anxiety Disorder: This is excessive worry or fear about a range of different things that happen in daily life. A child worries about the future more than other children.

Panic Disorder:  A panic disorder is a type of anxiety that also has intense physical symptoms like a racing heart, dizziness, feeling like they can’t breathe. A panic “attack” can come without warning and can go away within minutes to hours.

What can I look for if I think my child has anxiety?

• Some kids will say what they are afraid of: “I don’t want to go to school because the teacher might call on me in class?”
• Worry and/or cries more than other kids
• Complaints about being sick; upset stomach, headaches
• Trouble sleeping, nightmares, does not want to sleep alone
• Restless, jittery
• Anger easily
• Difficulty focusing
• Shaking
• Refusing to go to school
• Uses the bathroom a lot

What causes anxiety?

Some kids are just more sensitive and might have a hard time coping with change. These kids may have a biological or family tendency to be anxious. Anxiety can also develop after stressful life events such as:

• Death of someone close to them
• Moving to a new house or school
• Poverty: getting enough to eat, difficulty having a safe place to live
• Parents who fight and argue, or separation/divorce
• Abuse/neglect, bullying

Are there complications from anxiety?

Children with an anxiety disorder are at greater risk for depression and substance use disorders later life. There is also a higher risk for self-harm and suicide.

What can I do as a parent?

• The 3-3-3 Rule: Name 3 things you can see. Name 3 things you can hear. Move 3 body parts. This strategy incorporates multiple senses, distracts from the thoughts causing anxiety, and grounds the child in the present moment. Make this playful, practice when not anxious.
• Daily exercise
• A safe and supportive home and school environment
• Good sleep habits
• Well balanced meals
• Monitor screen time and social media
• Teach meditation and breathing techniques: Here are some free apps:

• Anxiety Free: iCan Hypnosis – Developed by hypnotherapist Donald MacKinnon, this app is designed to use self-hypnosis to help teach techniques for relaxation and altering subconscious thoughts.
• Sanvello* – Designed to be used in conjunction with therapy, this app teaches deep breathing and behavioral exercises. Users learn how to identify negative thinking patterns and replace them with positive ones. It focuses on the cause of anxiety and personalizes itself using voice recordings.
• Panic Relief*– This easy-to-use app uses evidence-based coping tools to help calm and safely move through a panic attack. Coping tools include muscle relaxation, rest, breathing and more.
• Self-Help Anxiety Management*– This app for older teenagers and adults focuses on mindfulness, or self-awareness. It helps users understand the causes of their anxiety and aids in monitoring them. It focuses on anxious thoughts and behaviors, and provides exercises to deal with them and private reflection.
• MindShift* – This app for adolescents and young adults teaches basic skills to manage anxiety disorders. It also helps manage performance anxiety, test anxiety and perfectionism. Users can choose among the coping strategies and “favorite” the methods that work for them. It also features a “Chill Out” tool, which uses breathing exercises, mental imagery and mindfulness. “Quick Tips” are included to assist with anxiety in the moment.
• Stop, Breathe & Think- Another mindfulness-driven app, Stop, Breathe & Think uses the foundational methods of meditations. This app allows users to track feelings before and after meditation and view yoga videos. The goal is to offer the chance and skills to breathe and think. Meditations are goal-oriented and constructed to help users calm down.
• Live OCD Free*– For children and adults with OCD, this app is designed to help aid cognitive behavioral treatment. It includes ERP (exposure response prevention) exercises and reminders, and offers personalization.
• Breathe2Relax*– This is an app, by the National Center for Telehealth & Technology, teaches breathing techniques to manage stress. The pace can be personalized for what is most relaxing to the user and includes a map to track personal progress. It helps manage fight-or-flight responses during panic attacks, aids in mood stabilization and anger control.
• Calm – Combining mindfulness and meditation to manage anxiety symptoms, this app is noted for its serene interface. It uses relaxing sounds and guided meditations to help the user stay calm.
• 7 Cups – This app functions as a confidential therapy chat room, allowing the user to talk about problems causing stress or panic, and connect with others dealing with anxiety disorders. It also has hundreds of mindfulness exercises and licensed therapists available.

What about professional help?

There are two main ways to treat child and teen anxiety: cognitive behavior therapy and medication therapy. Both of these treatments may work on their own, but they work better together; “pills don’t teach skills.”

The Behavioral Wellness Group has “one stop shopping” for help with your child or teen. We have therapists skilled in treating kids with anxiety, prescribers for medication, and if needed, an Intensive Outpatient Program (IOP) for Adolescents. Here is the link to our practice.

WEBSITE: https://behavioralwellnessgroup.com/

ADOLESCENT MENTAL HEALTH IOP: https://behavioralwellnessgroup.com/intensive-outpatient-programs/adolescent-iop/

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¹ “Ohio Child Mental Health Project: Factors contributing to child and youth mental health struggles.” Health Policy Institute of Ohio, July 2025.

²Child and Adolescent Health Measurement Initiative. (2022-2023). National Survey of Children’s Health. Data Resource Center for Child and Adolescent Health supported by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB).

Frank R. Ezzo, Ph.D., ABPP, LLC
The Behavioral Wellness Group
8224 Mentor Ave #208 Mentor OH 44060
P: 440 392 2222 #852 F: 440 565 2349
fezzo@behavioralwellnessgroup.com
www.behavioralwellnessgroup.com