Monday Medical: Anxiety in children |

Monday Medical: Anxiety in children

Susan Cunningham
For Steamboat Pilot & Today

If your child is struggling with anxiety, he or she is not alone.

“Anxiety is the most common emotional problem in children, affecting 8% of children ages 3 to 17,” said Dr. Sheila Fountain, a pediatrician in Steamboat Springs and a member of the medical staff at UCHealth Yampa Valley Medical Center. “That number increases to 25% if we look at just 13- to 18-year-olds.”

Below, Fountain outlines what normal childhood anxiety looks like and when it might be time to talk with a health professional.

When is anxiety normal?

It’s common to experience some anxiety through childhood. It can first appear as separation anxiety, in which babies as young as 8 months and toddlers show extreme distress when they’re separated from a parent.

During later childhood, normal anxiety can look like a fear of the dark or storms, worries about a parent dying or concerns about the monster in the closet.

Don’t be surprised if those fears and worries are intense at times. The key is that they eventually end.

“What distinguishes this as normal is the transient nature and resolution with calming reassurance from a parent,” Fountain said.

If your child is experiencing normal anxiety, it’s best to listen to and validate your child’s fear.

“Instead of dismissing their worry, acknowledge that other kids their age are also afraid of the dark,” Fountain said. “Then move on to helping them develop skills to be braver. Be patient, as change takes time. Recognize small steps and reward them.”

When is anxiety not normal?

“If the child’s fear or worry is intense, does not resolve with appropriate reassurance and interferes with how the child functions at home or school, then they may have an anxiety disorder,” Fountain said.

There are several different types of anxiety disorders, including:

  • Separation anxiety disorder: In this condition, a child has an intense fear of sleeping alone or recurrent nightmares about separation that leads to other symptoms, such as chronic stomach aches.
  • Generalized anxiety disorder: This anxiety disorder may cause children to worry about upcoming events, with worries lasting for longer than 6 months. “They often also struggle with perfectionism and can have fatigue, irritability, restlessness and trouble sleeping,” Fountain said.
  • Social anxiety disorder: Children with this condition may be extremely self-conscious and fear humiliation. They may struggle with developing friendships and participating in class. Remember that anxiety doesn’t show up only as fears and worries. Your child may be irritable and angry, have trouble sleeping or even complain of headaches, stomachaches and fatigue.

How is anxiety treated?

The good news is that anxiety disorders can be treated. Research shows that cognitive behavioral therapy helps.

“Cognitive behavioral therapy is based on the idea that changing the distorted thinking and dysfunctional behaviors can change the emotions,” Fountain said. “It teaches skills and techniques to reduce anxiety.”

In addition, a healthy lifestyle that includes adequate sleep, daily exercise and good nutrition, is crucial for managing anxiety disorders. Fountain also encourages children to learn relaxation techniques such as yoga, and has found that family therapy and school interventions may be helpful.

Sometimes, medication is beneficial. “Medications may help ease the feelings of anxiety and make cognitive behavioral therapy more effective,” Fountain said.

If you’re concerned about the level of anxiety your child is experiencing, especially if it’s interfering with his or her social life, school or extracurricular activities such as sports, then see your child’s primary care physician. The doctor will take a history of your child’s anxiety, do a complete screening and make appropriate referrals for therapy and on-going care if needed.

“Anxiety disorders are treatable, and most children will see signs of improvement in two to four weeks,” Fountain said. “Early treatment is important as it can help prevent future difficulties such as school failure, low self-esteem and substance abuse.”

Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at

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