Anxiety Disorders
Introduction to Anxiety Disorders
Anxiety disorders are conditions where worry or fear becomes too strong and lasts too long. In kids and teens, this can look like excess worry, irritability, trouble sleeping, stomachaches or headaches, school refusal, or panic symptoms (racing heart, shortness of breath). Types include generalized anxiety, separation anxiety, social anxiety, specific phobias, panic disorder, and (in some kids) selective mutism. These problems can affect school, friends, and family life—but they are treatable. If symptoms last for weeks or limit daily life, it’s time to get help. The U.S. Preventive Services Task Force recommends screening for anxiety starting at age 8.
Safety note:
If your child talks about suicide or has a plan to harm themselves or others, call 911 or go to the nearest ER. In the U.S., you can also call or text 988.
Causes and Risk Factors
There isn’t one cause. Anxiety usually comes from a mix of:
- Biology and genetics. Family history and brain chemistry can raise risk.
- Stress and environment. Bullying, conflict, loss, trauma, and big life changes can trigger or worsen symptoms.
- Temperament and development. Some kids are more sensitive to change or separation. For a few, speaking shuts down in certain settings (selective mutism).
Anxiety disorders are common—roughly 1 in 5 kids and up to 1 in 3 teens are affected at some point—so early assessment helps.
Treatment and Management
Care at Texas Pediatric Mental Health Services starts with a full evaluation. We review symptoms, medical history, and daily life at home and school. With your consent, we coordinate with your pediatrician and teachers.
What helps
- Therapy (first-line). Cognitive behavioral therapy (CBT)—often with gradual, supported exposure—teaches skills to manage body reactions, thoughts, and avoidance. Family involvement improves results.
- Medication (when needed). SSRIs are commonly used for moderate to severe anxiety; SNRIs are options in some cases. We start low, monitor closely, and review often. Many kids do best with CBT plus medication.
- School supports. Simple plans (e.g., check-ins, gradual return, test accommodations) can reduce school stress.
- Healthy routines. Steady sleep, activity, and practice of coping skills help maintain progress.
We set clear goals, track progress, and adjust the plan together. Most children improve with treatment.