Childhood Anxiety

It's no secret kids get anxious too. There are some anxieties that happen more often in childhood - like separation anxiety and specific phobias - but kids can also have more "adult like" anxieties, such as generalized worries, panic attacks, and performance fears.

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Click here to read a short blurb about each of the anxiety disorders that can occur in children, from the Anxiety and Depression Association of America (ADAA).

Anxiety Coping Skills for Kids

Here you can download a list of coping skills for kids and a similar list for teens, both created by Dr. Steadman. You can also find several of these coping skills, and more, online here. Lastly, this handout, also created by Dr. Steadman, is a useful addition to the coping skills handouts. It specifically focuses on worry. 

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As you review these coping skills, remember that kids, especially younger kids, often go about "relaxing" in different ways than adults. To adults, spending an afternoon lounging in a hammock might seem like a great way to spend a couple hours. To many children, "lounging" is pretty boring, and they'd prefer to play. So, remember to balance anxiety-specific coping with general stress management, and work to make these activities fun and engaging for kids.

What about meds?

While there are some medications your child can take for anxiety, we don't usually recommend them as a first step. Psychotherapy is very effective for anxiety. However, some kids and teens can benefit from a little help to take the edge off. If your doctor or therapist recommends medications, this section is a review of what you may want to know.

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There are a few classes of medicines for anxiety: antidepressants, antihistamines, and anxiolytics. Antidepressants are the best option. They don't work immediately, but they are relatively safe and can do a lot to take the edge off of anxiety. The antihistamine Atarax (hydroxyzine) can be used for predictable anxiety. If you know you are going to do something that stresses you out, Atarax can be used to reduce your physiological stress response and make that thing easier. But it can also make you sleepy, so there is a tradeoff of potential drowsiness. Anxiolytics generally should not be prescribed for ongoing anxiety management. They are habit forming and also make anxiety worse in the long run. Classic anxiolytics include Xanax, Valium, Ativan, and similar drugs. They are very powerful and will take away quite a bit of anxiety when taken, but when they are stopped after repeated use, that anxiety comes back with a vengeance, more intense and more persistent than ever before. It can be very challenging then to come off regular anxiolytic use. These drugs should be reserved for one time use typically in emergency situations. This is true for adults too. If you have these drugs (anxiolytics) and are taking them whenever you feel anxious, I suggest developing a plan to come off them and instead replace with healthier treatments.

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I am not a physician and do not prescribe any medications, but my consistent advice to physicians is to choose antidepressants (SSRIs) first, consider hydroxyzine for mild, situation-specific anxiety, and to never use anxiolytics outside the hospital.