Anxiety and depression don’t affect only adults. From 2013 to 2019, 1 in 11 children ages 3 to 17 was affected by anxiety, according to the Centers for Disease Control and Prevention (CDC). The same research showed that 1 in 5 adolescents ages 12 to 17 reported experiencing a major depressive episode.


Anxiety and depression in children and adolescents may appear as:


If your child has anxiety, they may experience uncontrollable and extreme fear with certain triggers. They may worry about the future or have intense attacks of fear that include a pounding heart and trouble breathing.


If your child has depression, they may feel sad and irritable a lot of the time. They may show changes in eating and sleeping patterns, lose interest in activities, or even engage in self-harm.


We’ll review some of the common signs of anxiety and depression in children, and how to offer support.






Children, like adults, can sometimes feel anxious and down. But unlike adults, children, particularly younger children, are not always able to express these feelings.


Children may not have developed enough self-awareness to pinpoint what they’re feeling. And sometimes, even when they sense that something is not right, they may not have the ability to put these feelings into words.


The U.S. Preventive Services Task Force is expected to recommend that children as young as 8 years old be screened for anxiety. They’re also considering screening adolescents as young as 12 years old for depression.


Recognizing the signs and symptoms can help you spot the disorders earlier and offer support sooner.


Signs of anxiety


According to the CDC, signs of anxiety include:



  • excessive fears about family, school, friends, or activities

  • worry about the future

  • changes in sleeping and eating patterns

  • physical symptoms such as stomachache, headache, muscle aches, or tension

  • restlessness or irritability

  • fear of making mistakes or being embarrassed


Signs of depression


Signs of depression include:



  • feeling sad and hopeless

  • loss of interest in activities that were pleasurable

  • changes in sleeping and eating patterns

  • listless behavior and feeling fatigued

  • loss of concentration

  • feeling worthless, useless, or guilty

  • self-injury

  • thoughts of death or suicide







When diagnosing your child with anxiety or depression, your doctor will need to rule out other conditions that may present with similar symptoms. Below is a list of related conditions with symptoms that are similar to those of anxiety and depression:




  • Panic disorder.
    Panic attacks are episodes of extreme fear that come for no apparent reason. Your child may react to these unexpected feelings of fear with shaking, sweating, rapid heartbeat, and feeling like they are dying.


  • Social anxiety disorder. This is more than exaggerated shyness. Children with social anxiety disorder experience such intense anxiety in social settings that they choose to avoid them entirely.


  • Post-traumatic stress disorder (PTSD).
    PTSD can develop in children who have experienced trauma. Symptoms can include difficulty sleeping and concentrating, feeling jumpy, and being easily irritated.


  • Bipolar disorder. This involves periods of intense lows that may include the symptoms of depression. Unlike with depression, however, people with bipolar disorder also experience periods of high moods.






If untreated, anxiety and depression can negatively affect your child’s social life and academic goals.



This can lead them to drop out of school, use substances, have trouble with relationships, and even think about or attempt suicide.


According to the National Institute of Mental Health (NIMH), a combination of medication and psychotherapy can effectively treat anxiety and depression.


Medication


Some doctors may prescribe medication to treat symptoms in children. Options include:


In rare cases, children, teenagers, and young adults under 25 years old may experience an increase in suicidal thoughts or behavior when taking antidepressants. If this happens, it’s more common in the first few weeks after starting or when the dose is changed.


Talk with a doctor immediately if your child is having suicidal thoughts after starting a new medication.


Therapy


The following types of therapy can complement medication:




  • Play, art, and drama therapy. This can help younger children who may be unable to express their feelings directly.


  • Cognitive behavioral therapy (CBT). This approach is effective in older children. CBT can help your child replace negative thoughts with more positive, effective ways of thinking. This can lead to more effective behavior.


  • Acceptance and commitment therapy (ACT). According to 2015 research, this uses acceptance and mindfulness techniques to help children learn to live in the moment. Children also learn to stop self-judging and, in this way, cope with unwanted thoughts or behaviors.


  • Mindfulness. Mindfulness can be part of CBT or stress reduction. Research from 2015 shows that mindfulness can help with anxiety disorders in youth.


  • Interpersonal psychotherapy. This approach can help your child communicate better with others and works to resolve relationship issues that lead to depression or anxiety.


  • E-therapy. According to a 2019 study, e-therapy involves computerized treatment programs. These involve the child completing 10 to 12 computerized CBT sessions, with some additional sessions for parents.


Natural remedies


If you’re interested in natural methods, you may consider yoga with your child. A 2020 review noted that yoga led to reduced anxiety and depression in young people.


Many people take St. John’s wort as an herbal remedy for anxiety and depression. But the Food and Drug Administration (FDA) has not approved St. John’s wort as a medication for this purpose.


The safety and effectiveness of other dietary supplements, including omega-3 fatty acids and S-adenosylmethionine, are being studied.


For more information on herbal remedies, other complementary approaches, and current research, you can visit the National Center for Complementary and Integrative Health website.


Lifestyle changes


Lifestyle factors are a promising avenue for helpful treatments for depression and anxiety. The American College of Lifestyle Medicine defines six core features of a healthy lifestyle:



  • doing regular physical activities

  • eating a diet with plenty of whole foods and plants

  • getting restorative sleep

  • managing stress

  • avoiding substance use

  • making positive social connections







Possible risk factors for anxiety and depression include:




  • Age. A 2021 study showed that as children move into adolescence, they are at a greater risk of developing anxiety and depression.


  • Gender. An older study showed that starting around ages 13 to 15, girls are twice as likely as boys to show signs of depression.


  • Race and Ethnicity. According to a 2010 review, children who are not non-Latinx whites are at a higher risk of anxiety and depression. This may be due to disparities in the health care system.


  • Overall health. A 2020 study suggests children with chronic or severe medical conditions are more likely to be depressed.


  • Hormonal imbalance.

    Research from 2017
     shows that imbalances of certain chemicals or hormones, including cortisol, may increase the risk of depression.


  • Environment.

    Research from 2017
     shows that children with sensitive temperaments, early life stress, and parents with mood disorders may have an increased risk of anxiety and depression.



COVID-19 and anxiety and depression in children



Research from 2021
 shows that the prevalence of depression and anxiety symptoms during the COVID-19 pandemic doubled. The rates were higher when collected later in the pandemic, in older adolescents, and in girls.







According to 2019 research, prevention of anxiety and depression in children should begin at an early age. A 2020 study suggests that developing social, emotional, and cognitive skills is key to preventing anxiety and depression.


The following steps can help parents and caregivers prevent anxiety and depression in children:



  • Teach your child to speak about their feelings and to label them.

  • Keep your expectations realistic.

  • Respect your child’s feelings.

  • Create regular daily routines where possible.

  • Model healthy eating and sleeping habits.






Can very young children get anxiety or depression?


Yes, preschoolers can also get anxiety and depression. A 2017 review estimated that 10 to 20 percent of preschool aged kids have an anxiety disorder.


Will my child’s anxiety or depression go away?


Yes. With early intervention, a combination of therapy and medication, and support from loved ones, most children can learn to manage their anxiety and depression. For some children, anxiety and depression may remain lifelong conditions.


Can I pass my anxiety or depression on to my child?




Research from 2017
 shows that very young children of parents with a history of depression are at higher risk of depression. This may result from genetics, parenting techniques, or seeing their parent be anxious or depressed.



It’s important to remember that just because you have anxiety and depression does not mean your children will develop it. Depression has


plenty of causes

.







All children can become anxious and sad at times, but prolonged and intense feelings of anxiety or sadness may indicate more than just a bad day. By recognizing the signs of anxiety and depression, you can help your child get a diagnosis and the right treatment.


While it may seem overwhelming at first, the journey you travel together toward coping and healing may be one of the most meaningful journeys of your lives.