Key Takeaways
- Anxiety and depression in children can look different than in adults. Symptoms often manifest as irritability, anger, physical complaints (like stomach-aches), or changes in behavior rather than just sadness.
- Persistent changes in behavior are a key warning sign. If fears, worries, or sadness last for more than two weeks and interfere with school, friendships, or family life, it’s time to seek a professional evaluation.
- Early diagnosis and treatment are crucial. Evidence-based treatments like Cognitive Behavioral Therapy (CBT) and family therapy can help children develop coping skills and improve their long-term well-being.
As a parent, it’s natural to worry when your child seems sad, anxious, or withdrawn. While all children experience emotional ups and downs, persistent and overwhelming feelings of fear or hopelessness can be a sign of an underlying mental health condition like anxiety or depression.
Recognizing the subtle signs in children is the first and most critical step toward getting them the support they need. Unlike adults, children may not have the words to express what they are feeling, often showing their distress through their behavior.
At SOM Medical Practice, our dedicated pediatric and mental health teams understand the unique challenges of pediatric mental health. We are committed to providing a safe, compassionate environment for children and families to find answers and effective treatment. This guide will help you understand the signs of anxiety and depression in children and know when it’s time to seek professional help.
1. Understanding Anxiety in Children
Fears and worries are a normal part of childhood development—from fear of the dark to anxiety about the first day of school. However, when these fears become excessive, persistent, and interfere with daily life, it may be an anxiety disorder. According to the CDC, anxiety in children can manifest in several ways. [1]
Common Types of Childhood Anxiety Disorders:
| Disorder Type | Key Features |
| Separation Anxiety | Extreme distress when away from parents or caregivers. |
| Social Anxiety | Intense fear of social situations, school, or interacting with peers. |
| Generalized Anxiety | Excessive, uncontrollable worry about a wide range of everyday things. |
| Phobias | An intense, irrational fear of a specific object or situation (e.g., dogs, storms, needles). |
Signs to Watch For:
Beyond simple worrying, anxiety in children often appears as physical or behavioral symptoms. Parents should be mindful of:
- Physical Complaints: Frequent headaches, stomach-aches, or general fatigue with no clear medical cause.
- Behavioral Changes: Increased irritability, anger, or having trouble concentrating.
- Avoidance: Refusing to go to school, avoiding social events, or being unwilling to participate in activities they once enjoyed.
- Sleep Issues: Difficulty falling asleep, staying asleep, or frequent nightmares.
2. Recognizing Depression in Children
Childhood depression is more than just feeling "blue." It is a serious mood disorder that can rob a child of their energy, joy, and self-esteem. The Cleveland Clinic notes that depression in children often presents as irritability rather than sadness, which can sometimes be mislabeled by adults as bad behavior. [2]
Key Symptoms of Depression in Children:
- Persistent Sadness or Irritability: A lasting sad mood or a tendency to be cranky, hostile, or easily frustrated.
- Loss of Interest: Apathy or lack of interest in activities that were once enjoyable, such as sports, hobbies, or playing with friends.
- Changes in Sleep and Appetite: Sleeping significantly more or less than usual, or major changes in eating habits leading to weight gain or loss.
- Low Energy: Feeling tired, sluggish, or lacking energy for daily tasks.
- Feelings of Worthlessness: Expressing feelings of guilt, self-blame, or low self-worth (e.g., "I can't do anything right").
- Difficulty Concentrating: A noticeable drop in school performance or struggling to focus on tasks.In severe cases, depression can lead to thoughts of self-harm or suicide. Any mention of these topics should be taken seriously, and professional help should be sought immediately.
3. When to Seek Professional Help
It can be challenging for parents to distinguish between normal childhood emotions and a potential mental health disorder. A good rule of thumb is to consider the duration, intensity, and impact of the symptoms.
Seek an evaluation with a healthcare provider if you notice the following:
| Indicator | Description |
| Duration | Symptoms persist for more than two weeks without improvement. |
| Intensity | The child’s anxiety or sadness seems extreme for the situation. |
| Impact | Symptoms are negatively affecting their schoolwork, friendships, family relationships, or ability to enjoy life. |
The first step is to schedule an appointment with your child’s pediatrician. They can rule out any underlying medical conditions that might be causing the symptoms and provide a referral to a mental health specialist.
4. How Are Anxiety and Depression Treated in Children?
Effective treatment for pediatric anxiety and depression is available and often involves a combination of therapy and, in some cases, medication. The goal is to give children the skills to manage their emotions and navigate life’s challenges.
- Cognitive Behavioral Therapy (CBT): This is a highly effective, evidence-based form of talk therapy that helps children identify and change negative thought patterns and behaviors. [1] For anxiety, a specific type of CBT called Exposure and Response Prevention (ERP) is often used.
- Family Therapy: Since a child’s well-being is closely tied to their family environment, involving parents and siblings in therapy can be extremely beneficial. It helps family members learn how to best support the child.
- Medication: In some cases, particularly for moderate to severe depression or anxiety, a healthcare provider may recommend medication, such as an SSRI. This decision is always made carefully in consultation with the family.
5. How Parents Can Support Their Child
As a parent, your support is invaluable. Creating a supportive and understanding home environment can make a significant difference in your child’s recovery.
- Talk Openly: Encourage your child to talk about their feelings without judgment. Let them know it’s okay to feel sad or scared.
- Validate Their Feelings: Instead of saying "Don't worry," try saying, "I can see that you're feeling really scared right now. I'm here for you."
- Focus on Healthy Habits: Ensure your child is getting enough sleep, eating nutritious meals, and engaging in regular physical activity, as these are all crucial for mental well-being.
- Partner with Their Healthcare Team: Stay actively involved in your child’s treatment. Communicate regularly with their therapist and doctor and help implement recommended strategies at home.
If you are concerned about your child’s mental health, you are not alone. The pediatric and mental health teams at SOM Medical Practice are here to provide expert, compassionate care for your entire family. Contact us today to schedule a confidential evaluation and take the first step toward helping your child thrive.
References
[1] Centers for Disease Control and Prevention (CDC). "Anxiety and Depression in Children." https://www.cdc.gov/childrens-mental-health/depression.html
[2] Cleveland Clinic. "Depression in Children." https://my.clevelandclinic.org/health/diseases/14938-depression-in-children
