Anxiety is the most common mental health problem in young people — research shows it affects roughly 1 in 12 children and as many as 1 in 4 teenagers. That's a striking figure, and it matters because anxiety disorders in young people often go unrecognised for years.
One reason they're easy to miss is that anxious kids don't always say "I'm scared." Instead they might have stomach aches before school, melt down over small things, refuse activities their friends enjoy, or cling to parents well past the age when that's typical. The challenge for parents and teachers is knowing when to be concerned — because some worry is completely normal and healthy.
A 2022 review in American Family Physician clarified how doctors and psychologists think about this. The key is whether anxiety is significantly interfering with a child's everyday life — school, friendships, family. When it is, the gold-standard treatments are CBT (talking therapy that gradually teaches the brain anxiety isn't dangerous) and, when needed, a specific type of antidepressant called an SSRI. Starting treatment early makes a real difference to long-term outcomes.
If you're worried your child's anxiety is more than normal stress, a conversation with a psychologist who works with young people is a worthwhile first step.
What exactly is 'an anxiety disorder' here?
Kowalchuk et al. group several related conditions under this umbrella: specific phobias (intense fear of a particular object or situation), social anxiety disorder (fear of social or performance situations), separation anxiety disorder (excessive distress when apart from a caregiver), agoraphobia (fear of situations where escape might be hard), panic disorder (recurrent sudden surges of intense fear with physical symptoms), and generalized anxiety disorder, or GAD (persistent, hard-to-control worry across many areas of life). These share overlapping features but differ in what triggers the fear and how it shows up.
Who is more likely to develop one
The review identifies several risk factors: having a parent with a history of an anxiety disorder, socioeconomic stressors (such as financial hardship), exposure to violence, and trauma. None of these guarantee a child will develop an anxiety disorder, but they raise the likelihood, which is part of why clinicians pay closer attention to children with these backgrounds.
Telling worry apart from a disorder
A central challenge is separating normal developmental fear from a genuine disorder. For example, separation anxiety is expected and healthy in infants and toddlers — it's a normal stage, not a red flag. This is why the U.S. Preventive Services Task Force recommends formal screening for anxiety disorders in children aged eight and older, while noting there isn't yet enough evidence to support routine screening in children younger than eight. Screening typically involves validated measures — standardized questionnaires with established reliability — completed by the child, a parent, or both, which help both with initial assessment and with tracking symptoms over time.
Symptoms can be physical and behavioral as well as emotional: the review notes things like diaphoresis (excessive sweating), palpitations (an uncomfortable awareness of one's own heartbeat), and tantrums, alongside the more commonly recognized worry or fear.
What actually helps
The review identifies cognitive behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs) as the main treatments, usable alone or together. CBT is a structured talking therapy that helps a person identify anxious thought patterns and gradually and safely face feared situations, teaching the nervous system that the danger is smaller than it feels. SSRIs are a class of antidepressant medication that increase the availability of serotonin, a brain chemical involved in mood and anxiety regulation, in the spaces between nerve cells. Kowalchuk et al. note that outcomes tend to be better when treatment starts early, when caregivers are actively supportive, and when different professionals involved in a child's care — such as pediatricians, therapists, and schools — coordinate with one another.
What this review can and can't tell us
This is a broad clinical review rather than a single trial, so it summarizes established knowledge about prevalence, risk factors, screening, and treatment rather than testing one specific new claim. It doesn't report effect sizes, exact numbers of children studied, or head-to-head comparisons of treatments, so it's best read as a map of current understanding rather than proof of any one detail.
If any of this sounds familiar from your own life or a young person's you care about, reaching out to a psychologist or GP is a reasonable and worthwhile next step.