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It\u2019s important for adults to be alert for possible signs of anxiety, so they can help children get treatment and support as soon as possible. Specific symptoms or anxiety-related behaviors can vary by the individual, but there are some things that can often be red flags.\u00a0 \u201cSymptoms of anxiety include avoiding the situation that triggers anxiety,\u201d says Dr. Takesha Cooper<\/a>, assistant clinical professor of psychiatry at the University of California Riverside School of Medicine and a child and adolescent psychiatrist at the Riverside County Department of Mental Health’s Lake Elsinore Family Mental Health Services. \u201cFor example, if a child is anxious about being away from a caregiver as in Separation Anxiety Disorder, that child will avoid scenarios in which they have to be apart from their caregiver. They might follow the caregiver through the house, express extreme anxiety or have a tantrum if the caregiver needs to leave.\u201d<\/p>\n Dorfman advises parents to watch out for any significant changes in daily functioning, particularly related to eating, sleeping and general mood.\u00a0\u201cParents should be aware of regressions.\u00a0For example, a child who has been fully toilet trained for over a year suddenly begins having frequent accidents or a child who did not have difficulty with parents’ departure at school drop off, may suddenly resist separations.\u201d\u00a0<\/p>\n It\u2019s common for anxiety in children to manifest itself in ways that mimic behavior issues or anger management problems. \u201cChildren with anxiety often worry about \u2018what might happen\u2019 so they might verbalize these worries out loud,\u201d says Cooper.\u00a0\u201cSome children when anxious can even become agitated and aggressive. This is their fight-or-flight that kicks in and can easily be mistaken for a disruptive behavior disorder, such as oppositional defiant disorder, or a mood disorder, such as bipolar disorder.\u00a0This is why it\u2019s important to have the child undergo a thorough assessment to understand their triggers and to talk to the child\u00a0to better understand what is going through their mind before and during these episodes, because it gives us a clue into why they behave the way they do.\u201d\u00a0<\/p>\n What should you do if your child has anxiety?\u00a0<\/p>\n \u201cFirst, take a deep breath and know that anxiety in children is fairly common,\u201d says Snell.\u00a0\u201cOne in ten children are diagnosed with anxiety disorders.\u00a0Getting your child help will require time, patience, commitment, and collaboration.\u00a0I strongly suggest you and your child see a qualified mental health professional who is trained to assess your child and partner with you in addressing your child\u2019s anxiety.\u00a0A professional can help you and your child learn effective tools to decrease your child\u2019s distress, apply the tools, and troubleshoot any issues as well as keep both you and your child motivated while monitoring progress.\u201d<\/p>\n Don\u2019t make them stifle their feelings. \u201cI tell them all feelings are okay but all behavior isn\u2019t,\u201d says Dr. Ashley. \u201cIt\u2019s okay to feel whatever they feel. Our culture has created this ideal that in order to be successful we must overcome these feelings.\u201d\u00a0<\/p>\n Parents need support, too<\/p>\n While the primary concern is the child with anxiety, family members\u2014especially parents\u2014can also benefit from helpful resources. \u201cParents greatly benefit from education about anxiety and treatment approaches,\u201d says Dorfman.\u00a0\u201cParents may contact pediatrician who is likely to be well versed in emotional issues of childhood and can refer the family to a mental health professional.\u00a0Ideally, the professional will work with parents in addition to the child to educate, provide strategies and resources so that parents may support child with compassion and understanding. Parents may also confer with teachers and may reach out to school social worker or psychologist for resources, support and referrals.\u201d\u00a0\u00a0<\/p>\n Treatment options<\/p>\n The traditional approach to treating anxiety was a two-pronged strategy: a combination of medication and therapy.\u00a0 \u201cThe two most common forms of treatment are Cognitive Behavioral Therapy (CBT) and Psychodynamic Psychotherapy,\u201d says Dorfman.\u00a0\u201cMedications which are commonly prescribed are SSRI (selective serotonin reuptake inhibitor) and\/or anti-anxiety and sedative medications.\u201d\u00a0<\/p>\n That\u2019s still the basic foundation recommended by many mental health professionals. However, these days, more medical and mental health practitioners are also incorporating other strategies into their recommended treatment plan, as we\u2019ll describe later.<\/p>\n Therapy\u00a0<\/strong><\/p>\n Dorfman says, \u201cThe most commonly used treatment approaches for children with anxiety are play therapy, for children under 12 or so; talk therapy; psycho-education (learning about anxiety); cognitive behavioral therapy; and parent guidance. Psychopharmacology\u2014meaning medications like SSRI and anti-anxiety medications\u2014are also effective, particularly when paired with therapy.\u201d\u00a0<\/p>\n Medication\u00a0<\/p>\n \u201cMedications can be effective and beneficial,\u201d says Dorfman.\u00a0\u201cThe introduction of medication is largely contingent upon the degree of impairment and the degree to which the anxiety interferes with daily functioning.\u00a0Often, patients are assessed and engage therapy before medication is introduced, though patients and situations vary significantly.\u00a0\u201c<\/p>\n \u201cMedication can be an important treatment for anxiety disorders, even in children,\u201d says Cooper. \u201cWe consider medication when the anxiety interferes significantly in a child\u2019s ability to function.\u00a0For example, if a child has severe generalized anxiety disorder and has been unable to attend school for weeks due to the anxiety, it would be helpful to consider adding medication to the treatment plan which should already include psychotherapy.\u00a0Or a child with Panic Disorder who has intense fear of future panic attacks such that she is unable to leave her home would benefit from a trial of medication to see if it helps her.\u00a0\u201c\u00a0<\/p>\n \u201cWhile these scenarios are severe, children with moderate anxiety can still be good candidates for medication, particularly if they are already receiving therapy but still are symptomatic,\u201d says Cooper.\u00a0\u201cOftentimes we see the medication can help children better utilize therapy because they are less anxious and more willing to discuss their anxiety or try anxiety reduction techniques the provider suggests such as exposures which are proven to help reduce anxiety.\u00a0For mild childhood anxiety, medications should generally not be chosen, given that good cognitive-based therapy by a trained clinician alone is often effective in reducing symptoms.\u201d\u00a0<\/p>\n Alternative or complementary treatment options<\/p>\n Alternative or complementary treatment options are no longer viewed with the type of skepticism as they were in the past. Even better, these days there is such a wide range of creative (and fun!) alternative treatments that there\u2019s something to fit everyone.\u00a0<\/p>\n \u201cIn the past decade or so, patients have increasingly used various forms of meditation and mindfulness practice,\u201d says Dorfman. \u201cPatients are encouraged to exercise regularly, journal and breathing techniques.\u201d\u00a0<\/p>\n \u201cI like to find what kids are interested in,\u201d says Ashley. \u201cGetting out in nature, doing art. Take a hike. You have to be in the experience of feeling joy and laughter. That gives the body a message that I am safe and okay. Talk therapy is important and helpful, so I like to combine several forms of therapy. I like to find something they enjoy doing that\u2019s more right-brained, because that\u2019s where the imprint happens. Try to make it as personal and customized as I can.\u201d<\/p>\n Examples of alternative\/complementary treatments\u00a0<\/p>\n Many people are surprised to discover the impressive\u2014and interesting\u2014range of treatment options available to help those with anxiety. Here are just a few examples of therapy types that can be used to treat anxiety.\u00a0<\/p>\n