Anxiety in children and adolescents can profoundly affect their emotional well-being, academic performance, social relationships and family life. Although feeling fear or worry is part of normal development, when anxiety becomes intense, persistent or interferes with daily life, it can become anxiety disorder that requires specialized assessment and individualized psychological treatment.

At the Child and Adolescent Psychiatry Unit, our objective is to help children, adolescents and families understand what is happening, identify the origin of the difficulties and offer effective tools to recover well-being, security and emotional autonomy.

How do I know if my son or daughter is anxious?

Child anxiety can be manifested in different ways depending on the age and personality of the child or adolescent.

The most frequent symptoms of anxiety in children and adolescents include:

Emotional and psychological symptoms:

• Excessive and constant worry.
• Intense fear of making mistakes or failing.
• Recurrent negative thoughts.
• Continuous need for security or reassurance.
• Irritability or emotional hypersensitivity.
• Low self-esteem and insecurity.

Physical symptoms of anxiety:

• Stomach pain or nausea without a medical cause.
• Frequent headache.
• Palpitations or feeling of shortness of breath.
• Muscle tension.
• Dizziness or feeling of blockage.
• Sleep problems or constant tiredness.

Behavioural symptoms:

• Avoid school or social situations.
• Difficulty separating from parents.
• Blockage in exams or everyday activities.
• Frequent crying or intense tantrums.
• Social isolation.

Types of anxiety disorders in children and adolescents

1- Separation anxiety disorder

It is one of the most frequent anxiety disorders in childhood. The child experiences an intense and disproportionate fear of separating from their attachment figures.

It can manifest through:

• Crying or intense distress when separating.
• Fear that something will happen to family.
• School refusal.
• Difficulty sleeping alone.
• Constant need for contact and security.

When this fear interferes with daily life and persists over time, it is important to carry out a specialized assessment.

2- Social anxiety

Social anxiety in adolescents and children appears when there is an intense fear of being judged, rejected or making a fool of oneself in front of other people.

It can seriously affect:

• Social relationships.
• Self-esteem.
• School participation.
• Personal autonomy.

Some frequent signs are:

• Extreme shame.
• Avoidance of presentations or social interaction.
• Fear of speaking in class.
• Mental blockage in social situations.
• Anticipatory anxiety before social events.

3- Generalized anxiety disorder (GAD)

The child or adolescent lives in a constant state of worry that is difficult to control. Worries usually focus on:

• School performance.
• Own or family health.
• Social relationships.
• Future mistakes or failures.
• Need to do "everything perfectly".

Generalized anxiety is usually accompanied by:

• Constant restlessness.
• Irritability.
• Concentration problems.
• Physical and emotional fatigue.
• Sleep difficulties.

4- Panic disorder

Panic attacks in adolescents can appear suddenly and unexpectedly, generating an intense feeling of fear or loss of control.

The most common symptoms include:

• Palpitations.
• Feeling of shortness of breath.
• Dizziness or trembling.
• Chest tightness.
• Fear of dying or "getting crazy".
• Feeling of disconnection or unreality.

After several episodes, many adolescents develop fear that it will happen again, beginning to avoid everyday places or situations.

5- Agoraphobia

Agoraphobia is an anxiety disorder in which certain situations generate intense fear due to the fear of not being able to escape or receive help if anxiety appears.

It can affect situations such as:

• Public transport.
• Crowded places.
• Open or closed spaces.
• Shopping centres.
• Leaving home alone.

This can cause significant isolation and limitation in daily life.

6- Specific phobias

Childhood phobias involve an intense and disproportionate fear of specific objects or situations such as:

• Darkness.
• Animals.
• Storms.
• Blood or wounds.
• Vomiting.
• Medical procedures.

When fear conditions daily life or generates great emotional suffering, early intervention is recommended.

7- Selective mutism

Selective mutism is a childhood anxiety disorder in which the child can speak normally in certain contexts but is unable to do so in specific social situations, or with people who are not from their circle.

It is not extreme shyness nor a lack of will, but an anxious difficulty that requires specialized intervention.

Why do child and adolescent anxiety appear?

Anxiety disorders do not have a single cause. Multiple factors usually intervene:

• Biological and genetic factors.
• Sensitive or perfectionist temperament.
• Stress or difficult life experiences.
• Academic or social pressure.
• Family or emotional difficulties.
• Experiences of rejection, bullying, or insecurity.