Reviewed by Angela T. Anderson, MD, Yesenia Marroquin, PhD, Amanda C. Riisen, PsyD
Reviewed on 12/29/2025
What is anxiety?
Feeling worried or nervous is a normal emotion. Many children and adolescents feel anxious about things like tests or competitions. Anxiety can show itself in physical sensations, too, including a racing heartbeat and muscle tension.
Anxiety can actually be helpful. It’s the body’s way of preparing to deal with stress or staying alert during challenging situations.
In children and adolescents, anxiety becomes a problem when the feeling is out of proportion to the situation, gets worse over time and negatively affects daily life. Excessive anxiety – or anxiety disorder – is one of the most common mental health conditions in children and adolescents, affecting about 30% of this population.
Anxiety disorders are serious mental health problems that can emerge suddenly or develop gradually. Common types of anxiety disorders include:
- Generalized anxiety — excessive daily or near-daily worry about many things; often includes physical symptoms, such as headaches, chest pain and stomachaches.
- Panic attacks — anxiety that leads to intense physical symptoms, including shortness of breath, dizziness, chest pain or numbness.
- Phobias — an intense fear of specific things or situations that do not pose an immediate physical threat, such as excessive fear of choking, dogs, thunderstorms or other bad weather, or insects.
- Social anxiety or social phobia — an intense anxiety caused by over-prediction of negative evaluation by others in social situations, such as speaking in front of the class.
- Selective mutism — a mental health condition in which an individual has difficulty or is unable to speak in certain settings, such as at school, during visits to the doctor, in the community or at work. Individuals with selective mutism are able to speak freely with select individuals, such as family members. While selective mutism typically affects young children, it can also be seen in adolescence and adulthood.
Signs and symptoms of anxiety
The symptoms of anxiety are different for everyone. Some examples include:
- Inability to stop worrying
- Avoiding non-dangerous situations that used to feel comfortable
- Feelings of panic (heart pounding, dizziness, shortness of breath and sweating)
- Feeling overwhelmed
- Butterflies in the stomach
- Stomachaches or nausea
- Fatigue
- Sleep problems
- Irritability
- Difficulty concentrating
Causes of anxiety
Everyone has feelings of anxiety occasionally, especially in response to stress. If a child or adolescent is attending a new school, for example, going to an unfamiliar place or preparing for a challenging school assignment, they may feel anxious or nervous for a limited time.
This type of temporary anxiety comes from the body’s natural way of dealing with stress. It goes away once the stressor has passed, usually within a day or a couple of days. When this type of anxiety resolves, the child or adolescent goes back to behaving as they typically do – settled and relaxed.
For children and adolescents with an anxiety disorder, anxiety is chronic, pervasive and interferes with their life. Some possible causes of an anxiety disorder include:
- A genetic predisposition to anxiety-based mental health conditions
- A learned behavior from a parent
- Exceptionally stressful life circumstances
In addition, experiencing a traumatic event can result in persistent anxiety, depression or a type of trauma and stressor-related disorder like post-traumatic stress disorder (PTSD).
Testing and diagnosis
An accurate diagnosis and early treatment are important in reducing anxiety symptoms and improving overall quality of life. If you believe your child or adolescent is experiencing an anxiety disorder, you can talk to their primary care provider (PCP) about it, and/or request a referral to a mental health provider.
A mental health provider can diagnose an anxiety disorder (or combination of disorders) and identify potential causes by:
- Asking your child or adolescent a series of questions about their life and behavior
- Assessing their symptoms, as well as symptom frequency and intensity
- Asking you questions about your child or adolescent’s behavior
- Evaluating the degree of disruption in your child or adolescent’s life caused by the disorder
Treatment of anxiety
Early treatment is key to reducing the symptoms of anxiety and improving overall quality of life. Based on your child or adolescent’s symptoms and specific disorder, their mental health provider will design a personalized treatment plan, which may include counseling, therapy and/or medication.
Types of therapy
Therapy sessions may last for several weeks or longer. The current options for treatment are highly effective in helping to manage an anxiety disorder. Some options include:
Individual cognitive behavioral therapy
In cognitive behavioral therapy (CBT), children and adolescents will learn distress tolerance and other coping skills for managing anxiety symptoms. If applicable, they will also learn strategies to combat any distorted thinking they may experience. They will also work with a therapist to gradually approach things or situations they have been avoiding. This type of treatment is time-limited, usually lasting 4-6 months.
Family-based cognitive behavioral therapy
The family meets together with a therapist to develop and carry out a plan for coping with anxious feelings and gradually approaching feared situations. Often family-based CBT is incorporated with individual therapy.
Medication
A mental health provider may recommend that your child or adolescent sees a physician who can prescribe a medication to reduce or prevent the feelings and physical symptoms of anxiety.
Outlook
Most children and adolescents who receive early and effective evidence-based treatment for an anxiety disorder will recover. However, in some individuals, the anxiety disorder recurs, or a different anxiety disorder develops. Sometimes, depression develops as well, given the impact an anxiety disorder may have on an individual’s life. Early treatment is key to minimizing your child or adolescent’s vulnerability to escalation of anxiety symptoms over time.
Follow up care
Depending on your child or adolescent’s personalized treatment plan, they may continue to meet with their mental health provider for several weeks or longer. As symptoms reduce over time, your child or adolescent may need fewer appointments, and may “graduate” from treatment. Their mental health provider may also recommend basic lifestyle interventions, like relaxation strategies, improved diet or sleep habits and exercise. If your child or adolescent wasn’t prescribed a medication initially, they may have a need for medication and medication monitoring at a later point.
Resources to help
Anxiety Resources
Child and Adolescent Psychiatry and Behavioral Sciences Resources
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