Getting Help for Your Child or Teen With Anxiety Problems

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To be able to effectively advocate for your child or teen with anxiety problems, you may first need to educate yourself a bit more. Anxiety disorders are the most common reason that children and teens seek mental health support. Despite this, anxiety issues are often missed, misdiagnosed, or misunderstood by mental health professionals who have not been adequately trained. Lay people, parents, and even mental health professionals are often confounded by the irrational nature of anxiety problems, their tendency to come and go, and what sometimes appears to be their peculiar nature.

The training I received in graduate school taught that life experiences, traumas, relationships, and the like caused anxiety problems. As a result, when I began working as a psychotherapist, I was woefully ill-equipped to treat many anxious individuals who sought my help. Talking about their anxiety didn’t help my clients overcome it. It wasn’t until a dear friend suddenly developed an extreme fear of flying that I took matters into my own hands and looked for better solutions. I learned about cognitive behavioral therapy (CBT), did additional post-doctoral training, started applying these methods with my clients, and have never looked back.

I believe parents need some basic information in order to make effective decisions regarding how to deal with anxiety problems. Three topics are helpful for parents—and kids—to understand: genetics, neurological differences, and perceptual differences.

Genetics

It is widely known that anxiety problems of all types have a strong genetic component (Shimada-Sugimoto et al., 2015). In my clinical practice, I treat many anxious young children and teens, and it is rare for them not to also have a family history of anxiety problems. The parent who brings the child to therapy may themselves suffer from anxiety. At other times, the parent may initially be unaware of their own family history of anxiety because older family members have hidden their anxiety issues.

Yes, some anxiety can be cause by trauma. For example, post-traumatic stress disorder (PTSD) results from witnessing or experiencing life-threatening trauma. However, up to 40% of individuals who develop PTSD have a genetic predisposition for it (Banerjee et al., 2017).

Neurobiological Differences

Researchers have identified various neurobiological and brain-related characteristics that predispose individuals—including children—to develop anxiety problems. Comparing the brain functioning of anxious individuals with that of those who are not anxious, researchers report differences in the neural activity levels of their amygdala (Forster et al., 2012). The amygdala is part of the brain’s limbic system and is responsible for the processing of fear and other emotions. Neuroimaging studies tell us that anxious individuals have overly sensitive amygdalas, which, once activated, stay activated longer than those of non-anxious individuals.

It is helpful to understand that when your child experiences fear, their amygdala is activated; this is a physiological condition, and it can lead your child to experience prolonged distress and fear.

Perceptual Differences

A child who suffers from an anxiety disorder will not fear everything. For example, one child may fear being in social situations, while another may fear germs or be afraid to eat certain foods. Although these forms of anxiety may be different, they have a common mechanism—that is, the brains of anxious individuals tend to interpret danger or potential harm in situations that pose no actual threat. It is as if the anxious brain has finely-tuned radar set to find and amplify possible dangers even where none exist.

In other words, anxious people perceive the world a bit differently than others do. Knowing this can be an important first step in overcoming your child’s anxiety.

Most people with anxiety problems will tell you that they know their fears are irrational or overblown, but they nonetheless feel terrified when they are triggered. This reflects the over-activation of the amygdala. When it’s hyper-activated, the person loses their rational perspective for the duration of heightened activity. Once it calms down, they regain perspective—until the next trigger.