When Is 'Anxiety' an Anxiety Disorder in Children?

Mary E. Muscari, PhD, CPNP, PMHCNS-BC


October 28, 2011

In This Article


When Does Anxiety Become an Anxiety Disorder in Children?

Response from Mary E. Muscari, PhD, CPNP, PMHCNS-BC
Associate Professor, Decker School of Nursing, Binghamton University, Binghamton, New York; Pediatric Nurse Practitioner, Psychiatric Clinical Specialist, and Forensic Clinical Specialist, Sex Offender Assessment Board / Pennsylvania Board of Probation & Parole, Harrisburg, Pennsylvania

Anxiety in Children and Adolescents

Stress is a fact of life, even for children. Childhood is full of typical stressors, including developmental stressors such as puberty and situational stressors such as moving and going to a new school. However, for some children, stress is more than a developmental norm; it is a full-blown anxiety disorder that disrupts their lives. Children with anxiety disorders are usually so afraid, worried, or uneasy that they become unable to function normally. Nurse practitioners (NPs) must be able to differentiate normal childhood anxiety from anxiety disorder so that affected children can receive proper and early intervention.

Anxiety disorders are the most common psychiatric conditions found in adolescents, and most adult anxiety disorders begin in childhood, adolescence, and early adulthood. Recent estimates suggest that 8%-22% of children and adolescents may suffer from an anxiety disorder.[1] In 13- to 18-year-olds, the prevalence of anxiety disorder is 25.1% and is 5.9% for severe anxiety disorder.[2]

Although very common, anxiety disorders in children are often overlooked or misjudged. Because a certain level of anxiety is normal, it becomes important to distinguish between normal and pathological levels of anxiety. The experience of anxiety often has 2 components: physical (such as headache, stomachache, and sweating) and emotional (nervousness and fear). Anxiety disorders, however, often affect children's thinking, decision-making ability, and perceptions of the environment. They can raise children's blood pressure and cause a number of physical ailments, including diarrhea, shortness of breath, and palpitations, and are frequently accompanied by other disorders, such as depression and substance abuse.


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