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Anxiety and depression: what parents and caregivers should know

Child looking sad, resting head on elbow

Mental health is becoming more commonly talked about and less stigmatized, which is a step in the right direction. Still, many adults are unsure of how to support children’s mental wellbeing. According to the Centers for Disease Control and Prevention, 9.4% of children aged 3-17 years (approximately 5.8 million) had diagnosed anxiety in 2016-2019. In the same time period, 4.4% of children aged 3-17 years (approximately 2.7 million) had diagnosed depression. Since the Covid-19 pandemic, it is estimated that 30-40% of youth have anxiety and depression, and many kids are not getting the help they need. Sadness and nervousness are normal human emotions, so how do you know what type of support to give your child? We’re sharing guidance from our clinical expertise to help you answer that question.

Also, you can listen to our podcast with Dr. Kanya on anxiety and how to help your child here, or wherever you listen to podcasts.  

What are signs of clinical depression? 

Sadness or other forms of low mood are part of being human, especially being a growing human. The thing to look out for is how intense the signs are and how long they last. 

Emotional signs 

  • For teens and tweens, clinical depression can look like sadness, anger, irritability, hopelessness, numbness and/or emptiness 
  • Loss of interest or pleasure in almost all activities and relationships 
  • Low self-esteem, feelings of worthlessness or guilt, exaggerated self-blame or self-criticism 
  • Trouble thinking, concentrating, making decisions and remembering things 
  • Ongoing sense that life and the future are grim and bleak 
  • Frequent thoughts of death, dying or suicide 

Behavioral signs 

  • For younger kids, it can present as defiance, irritability or impulsivity 
  • Loss of energy, insomnia or sleeping too much 
  • Changes in appetite 
  • Agitation or restlessness 
  • Slowed thinking, speaking or movements 
  • Body aches and headaches 
  • Social isolation 
  • Poor school performance or frequent absences 
  • Less attention to personal hygiene or appearance 
  • Angry outbursts, disruptive or risky behavior or other acting out 
  • Self-harm 
  • Making a suicide plan or attempt 

What are signs of clinical anxiety? 

Worry and nervous feelings are a natural part of life. It’s when they start to take over our lives that they need to be addressed. Just like signs of depression, it’s important to notice how intense the signs of anxiety are and how long they are lasting. 

General signs and symptoms 

  • Feeling nervous, restless or tense 
  • Having a sense of impending danger, panic or doom 
  • Having an increased heart rate 
  • Breathing rapidly (hyperventilation) 
  • Sweating, trembling, feeling weak or tired 
  • Trouble concentrating or thinking about anything other than the present worry 
  • Having trouble sleeping 
  • Experiencing gastrointestinal (GI) problems, stomachaches 
  • Headaches 
  • Having difficulty controlling worry 
  • Having the urge to avoid things that trigger anxiety 

Types of anxiety 

  • Generalized anxiety disorder – being extremely worried or nervous about things, even when there is little to no reason to worry  
  • Panic disorder – unexpected and repeated episodes of fear, along with physical symptoms like chest pain, heart palpitations, etc. 
  • Agoraphobia – the extreme fear of crowded places, leaving one’s home or being in places that may be difficult to escape 
  • Selective mutism – being unable to speak in certain social situations 
  • Separation anxiety disorder – intense or prolonged separation anxiety that may interfere with daily activities  
  • Social anxiety disorder (social phobia) – significant anxiety or embarrassment caused by every day interactions 
  • Specific phobias 
  • Anxiety disorder due to a medical condition 

How to support your child’s mental health 

Parents and caregivers are an important part of an informal web of support for young people. As well as supporting your child directly, encourage and facilitate positive relationships with extended family, friends and chosen family, faith and cultural communities. Use reputable online resources, books and other materials to supplement what you know. 

  • Check in, ask them what they’re feeling and how intensely they’re feeling it. 
  • Help them identify what they’re feeling and where they feel it in their body. 
  • Give them your full attention and avoid distractions. 
  • Validate their feelings. 
  • Use developmentally-appropriate information and language. 
  • Connect and model healthy coping strategies. 
  • Encourage them to fight anxiety by resisting the urge to isolate or avoid. 
  • With depression, make sure they are still participating in life even if they aren’t enjoying things as much as usual. Staying involved helps. 
  • Teach them about the 988 crisis line. They can text or call if they or someone they know is feeling overwhelmed and need to talk to someone. 
  • Ask them what they think would help. 
  • Respect their boundaries if they aren’t ready to talk. 
  • Create positive habits and routines around sleep, nutrition, movement and screen time. 
  • Spend quality time together. 
  • Take care of your own wellbeing. 

When should you seek help for your child? 

If informal support isn’t enough and your child isn’t functioning well or their level of distress is extreme, it might be time to get more formal support.  

Generally, if depression symptoms persist almost every day for 2 weeks or more, it’s a good idea to enlist professional help. If anxiety persists almost every day for 2 months or more, get help starting with your child’s school and/or health care provider. 

Formal support 

  • Primary care physician 
  • School counselor/social worker 
  • Outpatient mental health clinic/provider 
  • Community mental health center 
  • Intensive outpatient program 
  • Partial hospitalization program 
  • Inpatient hospitalization 

Your child’s primary care physician can make recommendations for interventions like therapy, medication or both. They will work with you and your child to find the best solution for your family. Many times, there is a waitlist for therapy and other treatments, so it’s best to get on multiple waitlists to make sure your child is seen as soon as possible. 

To learn more, please visit Children’s Mercy Kansas City’s Powering Families webpage to watch a recorded webinar about anxiety and depression in pre-teens and teens. 

Get help now: Call 911 immediately or go to the nearest emergency room if your child is making suicidal threats or actions. 

If your child is feeling overwhelmed or suicidal but not in a crisis right now: Call or text 988. The Suicide Prevention Lifeline is available 24 hours a day, 7 days a week in English and Spanish and is free and confidential. 

Clinical Assistant Professor of Pediatrics, University of Missouri-Kansas City School of Medicine