MindSG
Explore our suite of self-care tools and resources to help you better understand and manage your mental health.
- Understanding anxiety in children
- What is anxiety disorder
- How do anxiety disorders affect our child?
- Misconceptions of anxiety disorder
- Types of anxiety disorders in children
- Causes of anxiety disorders
- Identifying anxiety disorder in our child
- Getting professional help
- How can we support our anxious child?
- Managing caregiving stress and burnout
- Self-help tools for us to support our child
- Mental health services
Understanding anxiety in children
Feeling anxious every now and
then is a normal part of life, even for children. It is fairly common for
young children to have fears such as that of darkness, needles, or even
lizards, as they explore their surroundings.
Likewise, older
children undergo various emotional, physical and social changes as they
enter new environments. While these can be exciting for them in their quest
for new experiences and independence, new changes may also become a source
of worry and anxiety.
What is anxiety disorder?
Anxiety is the feeling of worry, nervousness, or unease
over anticipation of ill-defined threats. It is a common, normal, and an
appropriate emotion when dealing with daily stresses or problems.
For
most older children, these feelings will wear off. Even in younger children,
with reassurance and guidance from close adults, they will learn to overcome or
cope with these fears.
However, for some, feelings of anxiety are
persistent, excessive, and overwhelming to the point of adversely affecting
daily function. Should this happen, our child might be suffering from an anxiety
disorder, and a healthcare professional should be consulted.
Common misconceptions:
This is different from the feelings of anxiousness over situations such as going to a new school or preparing for an important test.
How does it affect our child?
If our child has anxiety disorder, they will frequently
have worries and fears that interfere with their daily activities. These
feelings are difficult to control, out of proportion, and can last a long
time.
This affects:
The way they lead their life
(e.g. avoiding situations that cause fear and
anxiousness)
Their ability to cope with challenges in school
How they manage demands of life or relationships
What are the different types of anxiety disorders among children?
What is it?
When a child worries excessively for at least a month about losing someone they are closely attached to (e.g. their main caregivers) and refuses to be physically separated from them.
What are its signs and symptoms?
Obsession with
someone they are closely attached
to:
- Feeling stressed when isolated from them
- Worrying about losing them
- Fearing something will harm them
- Afraid of being alone or away from them
- Not wanting to sleep without them nearby
- Complaints of headaches or stomach aches when separated from them
- Refusing to leave home without them
What is it?
When a child is unable to speak and communicate effectively in certain social situations. This should last for at least a month and does not include the first month of being in a new environment (e.g. new school).
What are its signs and symptoms?
Not speaking in
specific social situations where
they are expected to
(e.g. not
talking to someone in school despite
being comfortable doing so at home).
What is it?
When a child worries excessively for at least a month about losing someone they are closely attached to (e.g. their main caregivers) and refuses to be physically separated from them.
What are its signs and symptoms?
Obsession with
someone they are closely attached
to:
- Feeling stressed when isolated from them
- Worrying about losing them
- Fearing something will harm them
- Refusing to leave home without them
- Afraid of being alone or away from them
- Not wanting to sleep without them nearby
- Complaints of headaches or stomach aches when separated from them
What is it?
When a child is unable to speak and communicate effectively in certain social situations.This should last for at least a month and does not include the first month of being in a new environment (e.g. new school).
What are its signs and symptoms?
Not speaking in
specific social situations where
they are expected to
(e.g. not
talking to someone in school despite
being comfortable doing so at home).
What is it?
When a child has excessive and irrational fears of objects for 6 months or more. This ranges from thunder to lizards, or situations such as confined spaces, height, or flying.These objects and situations are not dangerous but provoke immense anxiety and avoidance.
What are its signs and symptoms?
Distinct fear or anxiety about a specific object or situation where they:
- Experience immediate and extreme fear
- Actively avoid the cause of the anxiety or try to endure it
Some children may have more than one anxiety disorder or
have other mental health conditions (e.g. depression)
at the same time. A healthcare professional will be able
to determine if our child has an anxiety disorder or
whether the anxiety symptoms they exhibit are normal for
their age.
Causes
There are generally three factors in understanding the possible causes of anxiety disorders:
Biological
This includes inherited
genetic traits or the amygdala (the part of our
brain that processes fear) being more reactive
when facing threats. Underlying health issues or
side effects from some medications may also
cause anxiety symptoms.
The doctor
may request for tests to look for signs of a
problem should there be suspicions that their
anxiety disorder is due to an underlying medical
cause.
Side effects of certain medications
Medications that may cause symptoms of anxiety disorder include:
- Adderall
- Ventolin
- Thyroid medicine
Underlying health issues
Medical problems that may cause symptoms of anxiety disorder include:
- Thyroid
problems
(e.g. hyperthyroidism) - Respiratory disorders (e.g. asthma)
Psychological
This includes having excessive negative thoughts when faced with unfamiliar situations or situations our child is uncertain about.
Social
This refers to lived
experiences such as traumatic events or the
environment we grew up in.
Traumatic
events can include:
- Experiencing the death of a loved one
- Getting into or witnessing a car accident
- Experiencing any form of abuse
- Being in an over-controlling or overprotective environment
- Experiencing neglectful parents
Signs and symptoms
General symptoms of anxiety disorder include:
Chest pain/discomfort
Cold, numb/tingly hands
and feet
Difficulties remaining calm and staying still
Dizziness
Excessive fear, panic, and feelings
of uneasiness
Heart palpitations
Shortness of breath
Excessive sweating
If we observe our child displaying these signs and symptoms, we
should bring them to consult a healthcare
professional. By seeking treatment early, the signs and
symptoms can be managed better.
Diagnosis
To diagnose an anxiety disorder, a healthcare professional
would conduct a detailed clinical interview in which
they would ask about your child’s:
- Past medical and psychiatry history
- Family history
- Current symptoms
- Growth and development history
- Impact on their functioning
- School-related information
- Home environment
- Relationship between your child and their main caregivers
Treatment
The treatment of an anxiety disorder in a child would
depend on what the anxiety disorder is and what its underlying causes
are.
For young children, treatment usually involves psychosocial
interventions and parenting strategies to help them overcome and cope with
their anxiety.
For older children, medication and psychotherapy, also known as talk
therapy, are effective treatments to help reduce the signs and symptoms of
anxiety disorders.
How to support our anxious child
Empathise and understand what they are going through
Avoid enabling their fears and concerns
Avoid putting pressure on them
Be mindful of what we say and do
Let our child talk about it if they want to
Set aside time for our child to worry
Ask how we can support them
Self-care matters
Taking care of our child with anxiety while juggling our own
life demands can take a toll on our physical and mental well-being.
Ultimately, the lack of self-care will make it more challenging for us
to care for our child.
Practising and prioritising self-care
will allow us to recharge and put us in a better state to provide our
child with the support they need during their struggles with anxiety.
Take a look at some tips on
managing stress
and
emotions to keep
ourselves healthy.
Useful self-help tools
BRAVE: Mental Health Study of Children and Adolescents in Singapore
IMH is offering free mental health and neurodevelopmental screenings for children born between 2007 and 2016 in Singapore, as part of a nationwide study. These screenings are available until the end of 2027 and include assessments for ADHD and ASD. Check if your child is eligible and express interest here.
What is it?
When a child feels anxiety or fear in certain or all social situations where interaction is involved. This can include:
It stems from a fear of being judged negatively by others
(e.g. doing something in front of others that is humiliating or embarrassing).
What are its signs and symptoms?
(e.g. having conversations, eating or drinking with others)