Most children have occasional worries or fears as they grow and develop. As a parent, you have most likely calmed a frightened child after a nightmare or had to dispel worries about monsters hiding under the bed. All of these childhood experiences are normal and common. However, when a child continually shows signs of extreme anxiety or fear, then it is possible that an underlying mental health issue is the cause of the child’s symptoms.

Signs and Symptoms of Extreme Anxiety or Fear

Your child may have extreme fear or anxiety if they:

• Worry about things before they happen
• Constantly worry about family, school, friends, or activities
• Feel shaky, restless, or tired
• Have shortness of breath, a rapid heart rate, or cold, sweaty hands
• Complain of stomach pain, headache, or dizziness
• Seem irritable and have difficulty concentrating or falling asleep
• Feel very nervous
• Feel as though every situation will end badly
• Speak of feeling helpless or powerless
• Have trouble sleeping alone and has nighttime fears or nightmares
• Resist going to school
• Argue with others and often stir up conflict
• Have a fear of embarrassment or making a mistake
• Have low self-esteem and lack confidence
• Engage in rituals or habits. For example:
  • Wash hands until the skin is chapped
  • Spend a lot of time putting things in order and feel distressed if the order is disrupted
  • Check doors or locks multiple times
  • Do things a certain number of times and feel distressed if it is not the right number.
• Start acting younger than his or her age. Some examples of behaviors include bed-wetting, clingy behavior, thumb-sucking, and sharing a bed with a parent.

Possible Mental Health Diagnoses

Possible mental health diagnoses within this symptom cluster include:

• Anxiety disorders
• Body dysmorphic disorder (BDD)
• Obsessive compulsive disorder (OCD)
• Post-traumatic stress disorder (PTSD)