Are you worried that your child might be suffering from anxiety? Today, Parents Ask expert Dr. Bonnie Zucker, author of Anxiety-Free Kids answers this question:

Q: What are tell-tale signs that my child might be anxious? Are there physical symptoms that might be obvious?



Anxiety is considered an internalizing disorder, which means the child's symptoms can often go unnoticed. This is in contrast to externalizing or disruptive disorders like ADHD or aggression. For this reason, parents need to be aware that many children exhibit "somatic" complaints: physical complaints or ailments that are psychological in nature. So, a child who often complains of stomachaches or headaches but has no organic or medical cause for these symptoms may, in fact, be experiencing anxiety.



Cognitive-behavioral therapy (CBT) considers anxiety to have 3 parts: physiological (body), cognitive (thoughts), and behavior (often avoidance). Typical physiological symptoms of anxiety include: muscle tension, shallow breathing, stomachaches, hot flushes, feeling dizzy or lightheaded, and restlessness. Many other symptoms could also be anxiety. If your child is having a panic attack, they may experience additional symptoms such as difficulty breathing or choking sensation, tingling in the hands or feet, heart palpitations, and feeling faint. It's always a good idea to see your child's pediatrician to rule out any medical problems, such as asthma; however, one way to determine if it might be anxiety is to notice if any patterns exist- when do they tend to have these physical symptoms or complaints? Is it only around bedtime or before school in the morning? This may indicate that it is anxiety associated with these situations (school, separation).