text: In This Article
  Anxiety and depression in children may go hand in hand since anxiety disorders can trigger depression, and anxiety can be a symptom of major (clinical) depression. Nearly seven percent of children may develop anxiety between three to seventeen years (1). Depression may occur in one in eight teens and one in 33 children (2).
  Anxiety is an emotional state with worry, tension, and physical symptoms such as sweating, shivering, increased blood pressure, rapid heartbeat, and giddiness (3). Sadness and lack of interest in activities can be present in children with depression. These mental health issues can harm a child’s normal feelings, acts, and thoughts (4).
  Read on to know about the signs, risk factors, and how to handle anxiety and depression in children and teenagers.
  How Do Anxiety And Depression Look Like In Children And Teenagers?
  Signs of anxiety in children and teens (5)
  - Unusual irritability and anger
  - Panic attacks
  - Episodes of intense and sudden fear
  - Excessive worry about social acceptance
  - Fears and worries about daily routines
  - Problems with concentration
  - Hypersensitivity to criticism
  - Extreme self-consciousness
  - Refraining from all forms of social activity
  - Avoiding difficult or new situations
  - Complains of stomach ache and headache
  - Refusing attending schools
  - Drop in school performance
  - Reassurance seeking behavior
  - Problems with sleeping
  - Headache and stomach ache
  - Phobias of specific things or situations, such as dogs, insects, or going to the doctor
  - Social anxiety by showing signs of being afraid of unknown people or school
  - General anxiety and apprehensions about the future
  - Panic attacks or experiencing repeated episodes of sudden, unexpected, or severe fear accompanied by symptoms, such as a rapid heart beating, troubled breathing, or feeling giddy, shaky, or sweaty
  - Serious concern about the future
  - Feeling sad and hopeless
  - Lack of interest in fun
  - Altered eating patterns— eating considerably more or less than normal
  - Altered sleeping patterns— sleeping considerably more or less than usual
  - Altered energy levels— being tired, sluggish, lethargic, tense, and restless frequently
  - Problems with paying attention
  - Reduced interaction with friends and family
  - Fluctuations in body weight
  - Inability to feel emotions
  - Feeling guilty, useless, or worthless
  - Exhibiting self-destructive behavior
  - Suicidal thoughts
  What Are Risks Factors Of Anxiety And Depression In Children?
  - Girls are more likely to develop anxiety than boys
  - Genetic inheritance
  - Acquired behavior from observing parental patterns of stress and anxiety
  - Bullying at school
  - Parental divorce
  - Chronic illness
  - Death in family
  - Lead exposure
  - Childhood trauma
  - Childhood domestic or sexual abuse
  The predisposing factors of depression are (2):
  - Substance abuse
  - Losing a parent or a loved one
  - Break up in a relationship
  - Learning disorders
  - Problems with paying attention or maintaining conduct
  - Long-term illnesses, such as diabetes and cancer
  - Childhood abuse or neglect
  - Experiencing trauma from road accidents, natural disasters, etc.
  - In childhood, both boys and girls are at an equal risk of having depression.
  - During adolescence, girls are twice as likely as boys to have depression.
  In some children, depression begins at an early age, even before these factors come into play, indicating depression originating from a chemical imbalance in the child’s brain. It is also believed that depression and anxiety may be genetically inherited, but certain environmental triggers are necessary to evoke the first episode of depression.
  How Can Parents Help Children Deal With Anxiety And Depression?
  - Recognize warning signs. If your child is experiencing one or a combination of the above signs, you should seek professional help.
  - Get the professional help they need. Problem acknowledgment by the parents is often the first step to healing. You can get the necessary help from your pediatrician, a mental health professional, a local mental health service, or other credible online resources.
  - Parents form the safety net for their children when they fall back. Give them the emotional support they need. Spend quality time with your child, encourage open and honest conversations, listen to your child, and acknowledge their struggles instead of disregarding them.
  - Parental expectations can be a source of stress for a child. Make them understand that you love them irrespective of how they perform at school or in sports.
  - Teenagers carry a lot of shame and self-blame. Having a strong connection with an adult can help them cope with anxiety and depression. Teens, at times, tend to push their parents away. In such scenarios, having a secure connection with a trustworthy adult, such as a teacher, a coach, school counselor, or a friend’s parent, can help them get the necessary support and guidance.
  - Talking about mental health at home and normalizing mental health problems can help your children feel safe to discuss their apprehensions with you. Try not to judge their feelings.
  - Engage your child in the physical activity of their choice. It can help reduce the severity of depression and is known to be a great stress reliever.
  - Help your children identify their feelings. Help them come up with ways to cope up with their negative emotions. It can be as simple as watching a cartoon or a funny TV show or something as therapeutic as a breathing exercise. For example, you can teach them the 3-3-6 breathing technique. It involves inhaling for a count of three, holding the breath for a count of three, and exhaling for six.
  Making conscious efforts such as the following can help manage your children or teens with anxiety and depression.
  - Do not disregard their fears and apprehensions
  - Maintain your cool when the child becomes anxious about a situation or an event
  - Appreciate their small achievements
  - Avoid punishing them for their slow progress or mistakes
  - Maintain predictable schedules
  - Modify your expectations when they are stressed
  Frequently Asked Questions
  1. When should I be concerned about my child’s anxiety?
  Besides being mindful of the symptoms, if your child’s anxiety persists for prolonged periods and interferes with everyday activities, you must take them to a mental health specialist.
  2. Can yelling at a child cause anxiety?
  Screaming or yelling at children and treating them too harshly when things can be dealt with calmly may lead to anxiety, behavioral problems, and depression (13).
  3. Can strict parents cause anxiety?
  Dealing with children in an overly critical and harsh manner may increase the risk for anxiety disorders (14).
  Anxiety and depression may not be common but need timely addressing could help. Professionals can help you treat your children by finding the triggers and underlying emotions at the root level.
  - Depression and anxiety can significantly hamper the quality of life for children.
  - Panic attacks, concentration issues, and reassurance-seeking behaviors are signs of anxiety in children and teens.
  - Irritability and altered sleeping and eating patterns are common signs of depression.
  - Recognizing warning signs, providing emotional support, and seeking professional help, if needed, can help parents deal with their child’s depression and anxiety.
  - Depression in Children.
  https://my.clevelandclinic.org/health/diseases/14938-depression-in-children - CHILDHOOD DEPRESSION.
  https://www.azcourts.gov/casa/training/training-courses/childhood-depression - Anxiety.
  https://www.apa.org/topics/anxiety - What Is Depression?
  https://www.psychiatry.org/patients-families/depression/what-is-depression - Anxiety and Depression in Children.
  https://www.cdc.gov/childrensmentalhealth/depression.html - Teens anxiety and depression: How worried should parents be?
  https://answers.childrenshospital.org/teens-anxiety-depression/ - How Anxiety Affects Teenagers.
  https://childmind.org/article/signs-of-anxiety-in-teenagers/ - Depression in children and young people.
  https://www.nhs.uk/mental-health/children-and-young-adults/advice-for-parents/children-depressed-signs/ - Malgorzata Dabkowska and Agnieszka Dabkowska-Mika; (2015); Risk Factors of Anxiety Disorders in Children.
  https://www.intechopen.com/chapters/48919 - 5 Things You Can Do to Help Your Child with Depression.
  https://www.childrenshospital.org/conditions-and-treatments/conditions/a/anxiety-disorders/symptoms-and-causes - Tips for Parents and Caregivers.
  https://adaa.org/find-help/by-demographics/children/tips-parents-and-caregivers - 5 Things You Can Do to Help Your Child with Depression.
  https://www.nami.org/Blogs/NAMI-Blog/December-2018/5-Things-You-Can-Do-to-Help-Your-Child-with-Depression - Why parents might rethink raising their voices.
  https://www.nami.org/Blogs/NAMI-Blog/December-2018/5-Things-You-Can-Do-to-Help-Your-Child-with-Depression - Lyndsey Juliane Chong et al (2020); The association between parenting and the error-related negativity across childhood and adolescence.
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