Children with Anxiety Often Don’t Get the Help They Need

A growing number of children under 10 are living with anxiety, but several factors keep many from receiving treatment.

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Over the past decade, anxiety in young people has increased 17 percent. Getty Images

Heather Matz began noticing symptoms of anxiety in her daughter when she was just 4 years old.

By the time her little girl started kindergarten, she was struggling with leaving her mom every day.

She’d also cry at the end of most days when Matz picked her up.

After a series of medical issues, the anxiety Heather’s daughter was experiencing became severe.

Today, Matz told Healthline that her now 12-year-old’s anxiety “affects her sleep, her eating, her emotional state, and her physical health. She regularly has an upset stomach, abdominal pain, headaches, and insomnia. She gets worked up easily, cries regularly, and struggles with self-esteem.”

Matz’s daughter isn’t alone in her experience with anxiety.

According to a recent report released by the Child Mind Institute, anxiety affects 30 percent of children and adolescents at some point in their lives.

The institute reports a 17 percent increase in anxiety among young people over the last 10 years. And the National Institute of Mental Health reports that of those who have anxiety, 8.3 percent experience severe impairment as a result of it.

“It’s hard, because you don’t want to overdiagnose this generation with mental health conditions,” Seattle Children’s Hospital pediatrician Dr. Cora Collette Breuner told Healthline.

“Adolescence is stressful in general, though probably more so for this generation than ours, because there is no real way to shut it off,” she continued. “Kids have 24/7 access to what their peers think of them. Which turns out to be a real struggle for most of the kids I see in my office.”

Treatment is available and can be effective, but the report from the Child Mind Institute found that 80 percent of kids with diagnosable anxiety never get the help they need.

Matz tried to get that help for her daughter. They began seeing a therapist in Oregon when she was 7 years old.

“Therapy at that time was tough, and she didn’t open up much,” Matz explained. “She didn’t like going and was hesitant about each appointment, but her doctor was extremely patient and worked with her well.”

Then they moved to California, and the therapy experience just got harder. Matz explains that her daughter grew incredibly anxious about therapy and couldn’t bring herself to even walk into the therapist’s office. Instead, she’d stand in the hall or doorway for her entire appointment.

“I would sit in the office and try to encourage her to come in. But after a couple of months of weekly appointments, the therapist became annoyed and said that there really wasn’t anything she could do to help her if she wouldn’t come in the office, that medication was the only option.”

Matz was frustrated herself. She understood the therapist’s point, but felt like she should’ve tried harder to ease some of her daughter’s discomfort and build a relationship rather than just pushing for her to come inside.

“The more she pushed, the more distant and anxious about the situation my daughter became,” she said.

Breuner points out a lack of therapists trained to work with children is one of the biggest barriers to treatment for young people with anxiety.

“Mental health programs available to most people are far away, or not geared towards children, or they don’t take insurance, or the copays are too high,” Breuner said. “It is a specialty to work with children and their parents, and while there are tons of therapists trained to do that work, there still aren’t enough.”

She also explains that plenty of kids aren’t telling their parents about what they’re experiencing, so parents don’t know their children are struggling. That means the onus falls on parents to really be paying attention to their kids and to pick up on the symptoms their children may not recognize as anxiety themselves.

Susan McClanahan, PhD, founder and chief clinical officer of Insight Behavioral Health Centers, told Healthline that parents may miss some of the signs simply because of the level of distraction we’re all experiencing on a day-to-day basis.

“You’re busy and your kid is involved in every activity. They’re watching iPhones and tablets at a really young age, and you maybe don’t quite see what’s going on, because there are a lot of really almost socially acceptable ways to withdraw,” she explained.

McClanahan provided Healthline with a list of symptoms parents should look for. They include:

  • headaches
  • stomachaches
  • physical distress (when they can’t put words to how they’re feeling)
  • not wanting to go to school
  • talking frequently about not feeling well
  • withdrawing from social opportunities
  • trouble sleeping
  • excessive fears
  • excessive worries
  • restlessness
  • hypervigilance
  • always being on the lookout for what might go wrong
  • performance anxiety
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Because children and teens don’t often tell their parents about what they’re experiencing, many parents don’t know their children are struggling. Getty Images

Both Breuner and McClanahan explain that treatment for these kids often involves exposure therapy, where the therapist works to help patients face the issues causing anxiety.

For example, if school is causing anxiety for a child, exposure therapy may involve driving to the parking lot together one session, walking out and sitting on the steps the next, entering the building after that, and so on until the child finds they can face their source of anxiety.

“It doesn’t always make their fears go away,” McClanahan explained, “but it shows them they can cope.”

When parents are able to identify that their child has anxiety, and when appropriate medical treatment can be sought out, McClanahan says it can be very effective quickly.

“Some of it is about simply helping kids have the language of emotion, because a lot of kids are emotion avoidant,” she explained. “It’s not OK to let your kid cry anymore. We have baby monitors to prevent that right from the start. We don’t give our kids as many opportunities to learn how to self-soothe.”

Nicole Fennig, a teacher in Milwaukee, Wisconsin, has seen some of that in her own classroom.

While speaking to Healthline, she identified a growing need for perfectionism among her students, many to the point that they’re afraid of trying new things for fear of not getting it right.

“Their self-esteem is very low. They think they are ‘terrible students,’ aren’t doing enough or being good enough,” she said. “There are no reasons for this, but they have this constant voice in their head telling them they just aren’t enough.”

She also sees parents as sometimes being the biggest barrier to kids getting the help they need.

“I think there is such a stigma attached to mental health, and so much judgment from other parents as far as treating children for anxiety or depression, that many parents seem reluctant to acknowledge their child needs help,” Fennig said.

Fennig believes some of her students would greatly benefit from talking with a child psychologist who could help them manage stress, anxiety, dealing with bullying, and other peer interactions.

However, she ultimately concludes they don’t often get that help because their parents seem to think “that going to a child psychologist means their child will be put on medication, and that’s so frowned upon in today’s society.”

McClanahan suggests starting with the child’s pediatrician. They may be able to refer children to someone who can help in their area.

She points out that school counselors can also potentially provide resources.

Getting the child and family involved in developing new coping skills can be helpful as well.

For her part, Matz isn’t giving up on getting her daughter the help she needs. Currently, that involves calming techniques they’re employing at home along with helping her keep a routine, warning her a day ahead of time when doctor appointments are coming up, and allowing her to sleep on an air mattress in their room when needed.

Matz has considered trying to find a new child therapist, but at this point even bringing up the idea sends her daughter into a panic. And while medication is something Matz would consider, her daughter has anxiety about that as well, thanks to the prescription commercials and their long lists of side effects.

“There may come a time when I insist,” Matz explained, “but for now we’re letting her guide her treatment.”

It feels like the only option they have at the moment. But for the time being, it seems to be working as well as anything else.

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