In many ways, Tucker is like lots of 7-year-old boys. He plays baseball and soccer, knows the name of every Star Wars character, and is obsessed with Minecraft. But after his mother tucks him in at night, scary thoughts pop into his brain and he can't let them go. "He worries so much about everything, like that someone might be outside his window or the house will catch on fire, that he often stays up all night in fear," says his mom, Joanna, of Darien, Connecticut, who didn't want to use their real names to protect her son's privacy. "I tell him that we're safe, and although he knows it's true, he just can't settle down his mind."
Even during the day, anything that deviates from the norm for Tucker can lead to an unraveling. "We were a few minutes late dropping him off for soccer practice, and when we arrived he was so worried that everyone was looking at him that he couldn't relax and join the group," Joanna recalls.
All kids get stressed sometimes. They'll have butterflies leading up to the first day of school or worry about being left out if their BFF plays with someone else at recess. Most kids will complain, maybe cry a little, and then move on. But for the estimated one in five kids in the United States who suffer from anxiety disorders (including separation anxiety, social anxiety, and obsessive-compulsive disorder), it's a major challenge to manage their worries. They ricochet through the child's head, getting more intense over time instead of naturally fading away. "No matter how much you answer an anxious child's questions or tell her things are fine, she can't absorb your reassurances," explains Tamar Chansky, Ph.D., author of Freeing Your Child From Anxiety.
In severe cases, kids with anxiety may stop eating, sleeping, or going to school. At the very least, their instability can set them apart from their peers, often at an age when fitting in is crucial. "Maya is so scared she'll do something wrong, like knocking over a toy and making a big noise, that she avoids playing with others," says a mom we'll call Lee of her 5-year-old daughter, who has social and separation anxiety plus OCD symptoms brought on by an obsessive fear of vomiting. "Therapy has helped her express her fears, and we've been inviting kids over so she can practice socializing on her own turf, but it's a constant struggle."
A child's anxiety can have a ripple effect on the entire family. "We pick our vacations based on which location we hope will have the least noise, and my husband and I are both exhausted at the end of every day," says Lee, who lives in Los Angeles. Since not all therapy is covered by insurance, dealing with an anxious kid can also add a financial burden to an already stressed family. It can be difficult for a marriage too: If the child tends to confide in only one parent, the other may be skeptical, wondering, "How can a kid be anxious when nothing bad has ever happened to her?" That's a question parents across the country, including me, ask themselves every day.Making Sense of Fears
My daughter has suffered from anxiety since she was in preschool. Although she talked seemingly nonstop at home, at school she'd become so frozen with fear that she didn't say a single word during the first half of kindergarten. She constantly asked us about earthquakes and floods, though neither was likely to happen where we live. She has the same DNA as her older sister and was raised in the same home, so why was one of my kids confident and calm while the other was wracked with worries?
"It's just the luck of the genetic draw," explains psychologist Steven Kurtz, Ph.D., president of Kurtz Psychology Consulting, in New York City, who specializes in childhood anxiety. "There's a sort of smoke detector in your head that's supposed to go off when the brain perceives danger, and it triggers the fight-or-flight response," says Dr. Kurtz. "In anxious kids, their smoke detector is set to a much more sensitive level, and they also have a much more dramatic reaction." In fact, research has shown that differences in stress response can be detected in babies as young as 6 weeks old, proving that nature is at least as important as nurture when it comes to anxiety.
There's a family connection too: Kids with an anxious parent are up to seven times more likely to have an anxiety disorder compared with kids whose parents are not anxious. (Neither my husband nor I have a history of anxiety; both of Tucker's parents have anxiety in their family.) The link is both biological and behavioral, explains Golda Ginsburg, Ph.D., professor of psychiatry at the University of Connecticut in Farmington. "There is an inherited risk, but when parents are overprotective or model their own fears, they increase their child's risk of anxiety."
Difficult situations, like the death of a relative, moving, or even the ongoing daily stress of having an unemployed parent or tough financial times can also push manageable anxiety into a full-blown disorder. "A major event can sometimes make a child feel like everything in life is changing and nothing is predictable," explains Dr. Chansky.
If your child's worries are keeping him from going to school, playing with friends, or taking part in other activities that he'd normally enjoy, or if he complains of headaches or stomachaches that don't have any medical origin, then he probably has a condition that requires treatment, says Dr. Kurtz. Another cause for concern: questions and fears that seem out of proportion to the situation and continue for six months or get much worse over time. For example, it's perfectly normal for a child to ask "Can that happen to us?" after seeing a news report about a house fire; it's not normal to obsess about that fire several months later.