Information for Parents

Everyone feels afraid at times. Feeling anxious can be very helpful. It is a natural respons that alerts you to danger. Your body gets ready to react, so you can run or fight. For example, your heart starts beating faster and your muscles tighten. This is a healthy reaction. When children have problems at school, at home or with their health, they may feel anxious about it, but these feelings usually disappear when the trigger for the anxiety disappears.

But some children and adolescents feel anxious often for no apparent reason. Or they are much more afraid than they should be in certain situations. For example, your child is afraid to go to certain places (a square or public transportation), or to do certain things (giving a talk, having a blood test). Or he or she worries a lot about anything and everything and, as a result, often has trouble sleeping or concentrating.

If a child feels anxious very often, suffers from it and avoids normal or important activities because of it, they may be dealing with an anxiety disorder. By avoiding things, the anxiety does not diminish. In fact, it often gets worse. For example, it can become increasingly difficult to go to school, make and keep friends, do fun things or work. In the long run, it often leads to other psychological and social problems as well.

Parents

What is anxiety and when does it become an anxiety disorder?

Everyone feels anxious or stressed from time to time. Anxiety is a normal and useful emotion that helps us respond to danger. It allows us to react quickly in threatening situations, for example through the fight-or-flight response.

However, sometimes people experience intense fear in situations that are not actually dangerous. This fear can be so overwhelming that it interferes with daily life — for example, by avoiding certain places or activities, or feeling so tense that it becomes difficult to concentrate or carry out everyday tasks.

When fear lasts for a long time and is out of proportion to the actual danger, and it causes significant distress, it may be a sign of an anxiety disorder.

How does an anxiety disorder develop?

An anxiety disorder can develop during childhood, adolescence, or adulthood. It usually doesn’t have a single cause, but rather results from a combination of several factors. Some of these are known as risk factors. They increase the likelihood of developing an anxiety disorder. Examples include personal traits, genetic predisposition, environmental influences, and major life events.

In contrast to risk factors, there are also protective factors. These are circumstances that help protect a person from developing an anxiety disorder. These may include personal traits such as self-esteem and self-confidence, a strong and supportive social network, and healthy coping strategies.

What are the different anxiety disorders?

Separation anxiety disorder

Someone with separation anxiety, also called abandonment anxiety, is extremely afraid of being separated from the person they are attached to. Often these are the parents or caregivers. When they are separated, they often experience homesickness and are extremely worried about the safety and health of their parents or themselves. Separation anxiety in children between the ages of 8 and 18 months is a normal step in emotional development. Separation anxiety disorder only occurs when the behavior is no longer age-appropriate.

Social anxiety disorder

Children with social anxiety disorder have a persistent fear of failing or being criticized in social situations, such as when giving a speech or interacting with others, especially peers. In such situations, these children may experience palpitations, tremors, sweating, blushing, diarrhea, and sometimes a panic attack. Children with social anxiety disorder therefore avoid social situations with peers, which can lead to school refusal. 

Specific phobia

A specific phobia is a clear and unrealistic fear of a specific object or situation, which significantly disrupts normal functioning. Someone with a phobia has a strong tendency to avoid the stimulus that causes the fear. In a child with such a phobia, it is not always clear to those around him that the child is afraid. Especially in young children, symptoms of a specific phobia can be masked by crying fits, tantrums or clinging behaviour. Exposure to the feared object or situation can lead to a panic attack. The different types of specific phobias can be roughly divided into specific fear of animals, natural phenomena such as storms and floods, fear of blood, injections or injuries, fear of specific situations, for example unknown company, and other types of fear.

Generalized anxiety disorder

Someone with generalized anxiety disorder is excessively anxious and worried about everyday issues. Without any direct cause, they worry a lot about things that could happen. For example, they worry about what is happening in the world, money, their own health and that of their loved ones, school or work performance, friends or a possible divorce of their parents.

Panic disorder/agoraphobia

Children and adolescents with a panic disorder regularly have panic attacks without a clear cause. These attacks come unexpectedly. A panic attack consists of, for example, an increased heart rate, sweating, dizziness, fainting and nausea. Often these panic attacks are so unpleasant that a fear of having a panic attack also develops. This can cause you to avoid busy situations from which you cannot easily escape. For example, you no longer dare to use public transport, go shopping or go to a busy square. Some people even do not dare to go outside at all. This is also called agoraphobia (fear of open spaces).

Selective mutism

Someone with selective mutism can talk, but does not talk in certain situations because they are afraid. It is also called speech anxiety. Someone with selective mutism often talks at home, but in other situations such as at school or in the store they do not. So they are selective with whom they do and do not talk. Selective mutism is not a hearing, speech, language, or mental disorder such as autism, but an anxiety disorder.

How can anxiety be treated?

If the symptoms disrupt daily life and hinder the child's development, it is wise to seek professional help. A referral to youth assistance can be arranged through the GP or the municipality (youth team or social neighbourhood team). Together with the practitioner, appropriate psychological help is sought.

In children and adolescents, cognitive behavioural therapy (CBT) is the most commonly used and effective treatment for preventing and reducing various anxiety disorders. CBT involves identifying and challenging anxious thoughts, as well as addressing avoidance behaviours. People who are afraid often try to avoid the situations that trigger their anxiety. While this may reduce anxiety in the short term, it reinforces the fear in the long term and prevents it from being resolved.

During CBT, children learn to replace anxious thoughts with more helpful and realistic ones. A key component of CBT is exposure therapy, in which the child is gradually exposed to the feared situation or object in a controlled way, helping them to overcome their fear. This process involves practicing how to break avoidance patterns. It is essential that the child continues to practice these skills at home between therapy sessions.

Where can I find reliable information?

Many organisations offer information or support for parents regarding anxiety in children.

Tips

Tips
  • Take the fear seriously
  • Make sure the child can talk about their anxiety
  • Create a safe environment
  • Make sure your child gets enough sleep, exercise, and healthy food

Frequently Asked Questions

When can I call the advice line?

You can call the advice line with all your questions regarding anxiety and stress in children. We are happy to think along with you.

When does it become too much and do you need to seek help?

If anxiety or stress interferes with daily functioning, for example, if someone is no longer sleeping well, working, or avoiding social contact then it is important to seek help. Start with your family doctor, for example. Early intervention helps prevent things from getting worse.

I am looking for help. Can KAS treat my child?

KAS is a Knowledge Center and not a treatment institution. We do not offer treatment ourselves, but work closely with recognised treatment institutions. Through them, we offer access to training and interventions.