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What is Anxiety, and How Does It Work?

By Caraline McDonnell and Cal Chertavian

Anxiety Feels Awful, Why Do We Need It?

At many points in our lives, we all experience varying levels of anxiety. You might feel worried about a hard test coming up, nervous about giving a speech in public, or anxious about paying your bills on time. While feeling anxious is uncomfortable for everyone, anxiety itself is not necessarily a bad thing. The experience of anxiety is a biological reaction meant to protect us from perceived signs of danger. When functioning as intended, anxiety can help us stay safe. For example, if you are driving in a busy intersection, feeling anxious can tell you to be cautious and help you to avoid getting in an accident.

However, anxiety does not always function as intended. For some people who are vulnerable to stress, their bodies can be overreactive to situations that aren’t actually threatening their safety. For these people, nervous feelings and heightened levels of anxiety can be triggered by small, even innocuous events. As a result, people with a predisposition to anxiety often experience symptoms of anxiety significantly more than their peers and it can impair their ability to function in day-to-day life. If the symptoms are persistent, excessive, and often occur in response to situations that aren’t dangerous, it could be considered an anxiety disorder.

Think of it like a fire alarm. Fire alarms go off when they sense smoke in the building. This is a response to a very real threat, fire! But sometimes fire alarms might be extra sensitive, going off simply because of steam emitted from a boiling pot of pasta. This isn’t the real threat of fire that the alarm is trained to detect, but it goes off anyway.

Our body’s alarm system, anxiety, is often triggered in two parts. The first alarm tells you when something bad might be about to happen. To do this, your body triggers nervous emotions and physical feelings that remind you to be cautious and vigilant. The second alarm goes off when the bad thing actually happens. It triggers you to take immediate action in escaping the threatening situation.

For some people, these alarms are triggered when there are real threats. For those who struggle with anxiety, the alarm system will be more sensitive, like the fire alarm that reacts to steam from a pot of boiling pasta. In this case, the alarm system can be triggered by non-threatening situations, but the feelings of anxiety remains as intense as if there were a real-life threat. For anxious people and kids, the alarm system will be triggered by these false alarms more often. So, it’s important to help ourselves and our kids identify when an alarm is true or false. A primary goal of anxiety treatment will be to help children identify which alarms are false and how to reduce the frequency of these false alarms.

What Does Anxiety Feel Like?

Whether your body is giving you a true or a false alarm, the anxiety response will feel the same. These symptoms of anxiety manifest both as anxious thoughts and as anxious feelings in the body.

Anxiety often encompasses a state of negative expectation and heightened anticipation for the feared situation. For example, if a child is worried about what their peers think of them, they might consistently be ruminating on how they appear to others, overthinking comments they have made, or overanalyzing things that a friend may have said to them. Or, if a child fears bugs, they might start thinking about what kinds of bugs might be hidden in the grass and what would happen if they were bitten, even before opening the front door.

These anxious, repeating, and intrusive thoughts are most often accompanied by physical symptoms. When worried about a situation, a child might also feel nauseous, feel their heart beating faster, have a difficult time breathing, have a hard time sleeping well, get sweaty palms, or have a headache. For example, a kid who is nervous about doing well in school might get a stomachache and feel physically sick before a test. Especially with younger kids, these physical symptoms might stand out since they don’t have the vocabulary or awareness to verbally express their feelings of anxiety.

What Kinds of Anxiety Impact Kids?

Anxiety is an umbrella term; there are many different types of anxiety that it encompasses. Let’s delve into the spectrum beneath this umbrella and explore the distinctive disorders that make up the broad canopy of anxiety.

Generalized Anxiety Disorder

People with Generalized Anxiety Disorder (GAD) experience a persistent free-roaming anxiety that has no identifiable source or cause, but it typically relegated to a few primary topics at a time. Those with GAD may experience intense nervousness about a variety of topics, such as “what if” worries about the future (e.g., “What if I fail a test and then I don’t get into college and then I never get a job,”), worries about past behaviors (e.g., “Did I sound weird when I was hanging out with my friends earlier), worries about performance and perfectionism characterized by overpreparation and sometimes freezing up, as well as worries about existential threats (e.g., climate change, war), and health-related concerns. People who experience GAD often have strongly associated somatic symptoms to their anxious distress.

Social Anxiety Disorder

Those with Social Anxiety Disorder feel extreme nervousness in most social situations and often ruminate on past, present, and future negative evaluation from their peers. Someone with social anxiety might feel intense anxiety when ordering food at a restaurant or asking a stranger for directions. For youth with social anxiety, they might struggle in performance situations, such as being called on in class or performing in a recital, for fear of being embarrassed or judged by others.

Specific Phobia

Individuals with a Specific Phobia are acutely afraid of one or more specific things, places, people, or situations. These phobias could look like an intense fear of bugs that prevents someone from ever stepping outside, or a persistent fear of cars that prevents them from ever driving. Other classic phobias include fear of shots, requiring physical restraint to get a shot or missing shots and vaccines for several years, a fear of dogs or other animals, or a fear of heights and enclosed spaces.

Panic Disorder

People with Panic Disorder experience panic attacks – an intense wave of anxiety, shortness of breath, or tightness in the chest that may feel like a heart attack. Someone with panic disorder experiences these attacks frequently, and they typically occur without any obvious trigger. These panic attacks become so anxiety producing that people with Panic Disorder avoid situations that might elicit another panic attack.


Individuals with Agoraphobia have an intense fear of places where it may be difficult to escape or where help may not be available if needed. Someone with Agoraphobia may feel incredibly anxious in entering large crowds, using public transit, or entering small spaces like an elevator.

Separation Anxiety Disorder

Separation Anxiety Disorder is characterized by people who feel intense anxiety when having to be away from important people in their lives. Separation anxiety is most prevalent for children who fear being apart from their caregivers. For example, a child with Separation Anxiety Disorder may become extremely distraught during drop-off time at school, or won’t be able to sleep in a separate bedroom at night. Separation worries are often accompanied by a fear that harm might occur to a caregiver or the child that would result in them never seeing one another again.

Selective Mutism

Those with Selective Mutism experience an anxiety of speaking in front of others so intense that they are physically unable to speak, although they are fully capable of age-appropriate communication. A child with Selective Mutism may go through an entire week of school without saying a single word, making it almost impossible for them to ask for help. Typically, youth with Selective Mutism speak loudly and fluently with those whom they are familiar and comfortable, but freeze up and are silent with less familiar people and in new, or unexpected social situations.

Obsessive-Compulsive Disorder

People with Obsessive-Compulsive Disorder (OCD) have intrusive and anxiety-provoking patterns of thought that force them to develop rigid rules and behaviors to calm their anxieties. People with OCD experience intrusive thoughts, called obsessions, and then engage in repetitive behaviors, called compulsions, that help to neutralize or get rid of the intrusive thought. For instance, a child who has OCD might have obsessive thoughts about getting sick, leading them to compulsively wash their hands every time they touch a doorknob. They then believe they do not get sick because they washed their hands so thoroughly, reinforcing the compulsive behavior and creating an association between the thought and the compulsion that gets hard to break.

How Come Some Kids Are Likely to Struggle With Anxiety More Than Others?

The basic biological system that anxiety stems from is our fight or flight response to danger. When faced with a dangerous situation, your heartbeat and breathing rates will increase, and you will feel a rush of adrenaline. The same thing is true of anxiety in response to false alarms.

Some kids, and people, might have more sensitive alarms and experience anxiety more often. The causes of anxiety disorders are not completely understood, but genetics and inherited traits are likely to be a factor. If parents are more prone to anxiety, it’s likely that their child might be more anxious too. There are some factors that we know might make the development of an anxiety disorder more likely. These factors include witnessing or experiencing a traumatic event, increased stress buildup in daily life, and previous diagnoses of other mental health disorders. Although, if your child does have an anxiety disorder, it does not mean that they have experienced one or any of these risk factors.

Why Does It Matter?

The treatment of anxiety is more important than ever as the identification and diagnosis of anxiety disorders is on the rise. About one third of children between 3 and 18 will have a diagnosable anxiety disorder during their lifetime. Kids who are anxious are at a higher risk for school refusal, diminished academic performance, inhibited social skills, other mental health challenges, and future substance use issues. In recent years, an estimated 30% of adults have been impacted by anxiety. Addressing childhood anxiety early on can be protective for their quality of life as they grow up and enter adulthood. If left untreated, anxiety can impact physical health through increased blood pressure and cortisol levels down the line. It will also hinder quality of life, and one's ability to engage with life to their full potential.

Addressing anxiety through assessment, diagnosis, and mental health treatment in childhood is a great way to help set your child up for success. Luckily, we know of many effective treatments for childhood anxiety, and even some skills that you can use at home to help your child be brave! 

Want to learn more?

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