Anxiety in children is a problem for many parents. You may be asking yourself, “Why does my child suffer with panic attacks? Is it something hereditary or is it the way my child is brought up? What causes phobias? Why my child is afraid of something they know is not dangerous? What causes obsessions and compulsions to develop?”

The symptoms of anxiety in children often seem irrational and it is natural to ask yourself WHY? But before considering the causes of anxiety in children, there are two things you should bear in mind:

First, although learning about the causes of anxiety in children can give you an idea about how anxiety and symptoms of anxiety in children develop, such knowledge is not necessary to help your child overcome their anxiety. The strategies for overcoming anxiety in children – such as relaxation, exercise, desensitization, changing beliefs about self and dealing with feelings – can be effective even without the knowledge of the cause of anxiety in children.

Second, remember that there is always more than one cause for an anxiety in children. Whether your child suffers with panic attacks, social anxiety disorder, generalized anxiety disorder, separation anxiety or obsessive – compulsive disorder, keep in mind that there is always more than one factor causing the anxiety in children. Possible factors for anxiety in children include heredity, family background, biological makeup, upbringing, conditioning, recent stressors, your child’s self – talk and personal belief, their ability to express what they feel and others. Some experts in the “children with anxiety” problem promote a single cause theory. A single cause theory however is thought to oversimplify causes of anxiety in children. The two ways of looking at the problem are:

The Biological Fallacy and The Psychological Fallacy

The Biological Fallacy assumes that anxiety in children is caused solely by biological and physiological imbalance in the body. For example panic disorder is viewed as a dysfunction in parts of the brain, such as the amygdala and locus coeruleus. Obsessive – compulsive disorder is thought to be caused by a deficiency in serotonin – a neurotransmitter in brain responsible for feeling of well-being, mood regulation, appetite, sleep and cognitive functions such as memory and learning. This knowledge is very useful and plays an important role in treatment of children with anxiety; however it does not mean that anxiety in children is defect at physiological level only. We can ask, “What caused the physiological defect in the first place?” Perhaps it was chronic stress or chronically suppressed anger. Chronic stress and suppressed anger may then have been caused by your child’s upbringing. That is why it would be wrong to assume that anxiety in children is solely caused by a physiological imbalance in the brain.

The Psychological Fallacy on the other hand assumes that anxiety disorders such as social anxiety disorder or generalized anxiety disorder in children are caused by being neglected, abandoned or abused resulting in insecurity or shame. It is true that a family background contributed to your child’s current anxiety, but can it be the only cause? Not really. After all, not all children who grow up in dysfunctional family develop anxiety disorder. It is more likely that anxiety in children is a result of a hereditary predisposition towards anxiety and early childhood conditions that fostered a sense of shame and insecurity.

In sum, biological (= physiological) disturbances may be initiated by stress or psychological factors and psychological problems may be influenced by inborn biological imbalances. Therefore treatment of anxiety in children such as panic attacks or generalized anxiety disorder in children needs to consist of a variety of strategies on biological, behavioral, emotional, mental and interpersonal level may be necessary for a full and lasting improvement and recovery.

The causes of anxiety in children vary according to the level at which they occur (biological or psychological) and according to the time over which they last. Some are long term causes, which set your child up from birth or childhood to develop panic or anxiety disorder later on. Some are recent or short – term causes – circumstances that trigger the onset of anxiety in children. Other causes are called maintaining causes – current lifestyle, attitudes and behavior that keeps anxiety in children going once it has been set off.

Have a look at The Anxiety-Free Child Program. It is a recommended program designed for children with anxiety. Anxiety in children is likely to follow them into their adulthood if left untreated.

Causes of Anxiety in Children and Adults

Long Term Causes of Anxiety in Children

1) Heredity: Is Anxiety in Children Inherited?

Anxiety in children, as the evidence to date suggests, is partially inherited. For example, it is estimated that 15-20% of children growing up with an agoraphobic parent become agoraphobic themselves. This fact in itself doesn’t prove that agoraphobia is inherited, however, because children could learn to be agoraphobic from their parent’s behavior.

Studies of identical twins (identical twins have identical genes) revealed, that if one identical twin suffers with an anxiety disorder, the probability of the other identical twin suffering with an anxiety disorder is between 31-88%.) The probability of fraternal twins, whose genes are no more similar than those of siblings born at different time, is much lower. If one fraternal twin suffers with an anxiety disorder, the probability of the other one having an anxiety disorder is 0-38%. Having the same genes as another person with an anxiety disorder makes it more than twice as likely that you will suffer with the same or similar anxiety disorder.

So what is it that is actually inherited in terms of causes of anxiety disorders? It is the general personality type that your child inherited from you, not a specific phobia or anxiety in children. If your child inherited a personality that is more sensitive to only slightly threatening situations, they are more likely to develop an anxiety disorder, depending also on the way they are brought up and the environment they grow up in.

2) Childhood Circumstances – Anxiety in Children

Not enough research is available about this topic, however we know from experience, that childhood and family environment plays an important role in predisposing your child to develop anxiety in children.
Parents of children with anxiety or phobias often suffer with anxiety themselves. They are often overly cautious and worried about dangers to their children. They say things like: “Wear more warm clothes when you go outside, or you get ill.” Or “We are not important, other people are more important than us.” Or “If you watch too much television, you will damage your eyes”. Anxious thoughts like this repeated to a child again and again can surely make your child anxious and overly worried about various things.

Another cause of anxiety in children can be having highly critical parent or parents. They make their children anxious about whether they are “good enough” or if they have to work much harder in order to satisfy the parent and the world. This can cause that when your children grow up, they will suffer with constant insecurity and feel that they have to be nice and look great at the expense of their true feelings or wishes. Being insecure all of the childhood could cause your child to become dependent on a “safe” person and choosing the wrong type of relationships. Your children with anxiety could then copy your expectations when they become parents.

Emotional insecurity and anxiety in children can be caused by divorce or death in family, physical or sexual abuse, neglect or rejection, alcoholism of one or both parents. Whether children develop anxiety disorder later on depends on whether they respond to insecurity with excessive dependency, which is common for agoraphobia anxiety disorder in children.

If parents suppress their children’s feelings, for example by punishing them for speaking out, being impulsive or feeling angry, they will then learn to suppress their feelings and impulses. If they suppress them for long enough time, they may result in a panic attack. Being suppressed as a child can lead to anxiety in children and depression in children. Therefore learning to express your feelings and being assertive is an important part of the treatment when dealing with panic attacks.

• Cumulative Stress in Adults and Children with Anxiety

Stress that lasts long enough (months or years) accumulates. Long term stress is different to a normal short term stress, it can be caused by a an unresolved psychological conflicts, such as a difficult time in life (divorce) or several life events or life changes (good or bad) that caused stress. One or two important life events or changes per year are considered manageable, but anything more than that can result in chronic stress, exhaustion, anxiety and panic attacks.

• Examples of Life Events Causing Stress and Anxiety in Children and Adults:
  
  Death of husband or wife/ parent
  Divorce
  Jail
  Death in the family
  Personal illness or injury
  Marriage
  Losing job
  Marital problems
  Retirement
  Family member being ill
  Pregnancy
  Sexual problems
  New baby
  Business problems
  Change in financial situation
  Death of close friend
  Change at work – work hours, position, responsibilities
  Arguments with spouse
  Mortgage
  Children leaving home
  Problems with in-laws
  Personal achievement
  Beginning or finishing of school
  Change in personal habits
  Problems at work with colleagues or boss
  Moving home
  Holidays
  Christmas
  Diet

It is a known fact that stress can cause a psychosomatic illness such as headache, stomach ulcer or hypertension. Cumulative stress can cause psychological illness. Chronic or cumulative stress creates changes in the neuroendocrine centers in the brain. These centers play an important role in mood and anxiety in children and depression.

Stress has the greatest impact on your weakest point of your body. It can be your heart, stomach or your head. If your weakest point is the neuroendocrine center in your brain, you will be prone to anxiety and mood disorders such as depression, generalized anxiety disorder or panic attacks.

From what has been discussed above, we can say that genetic makeup, long term stress and childhood experiences and circumstances all contribute to anxiety disorders.

If you think your child may suffer with anxiety or panic attacks, take a look at The Anxiety-Free Child Program . It is a recommended program designed for children with anxiety and panic attacks.

Biological Causes of Anxiety in Children and Adults

This means physiological imbalances in the body or brain. These imbalances may be caused by genetic predisposition or cumulative stress and may not be necessarily the ultimate causes of anxiety in children.
Recent research revealed different types of biological explanations for different anxiety disorders in children. Biological imbalance in panic attacks in children is probably different from imbalance which occurs in generalized anxiety disorder in children. And biological imbalance in panic attacks in children and generalized anxiety disorder in children is again different from the one in compulsive-obsessive disorder in children. Each of these is explained below in further detail. It is, however, necessary to say that not enough research has been done in the field of biological causes underlying anxiety in children and the mechanism described below should be viewed as hypothetical, not proven facts.

Having biological imbalances in your body doesn’t mean that there is nothing you can do about it and you should accept your or your children’s anxiety as something you can’t do anything about. If you are willing to make the effort to reduce your daily stress and try to improve your physical well-being, the physiological imbalances associated with panic attacks, generalized anxiety disorder or obsessive-compulsive disorder will tend to diminish and maybe disappear altogether. You can reduce your daily stress by making time for relaxation, self-nurturing activities, good nutrition and exercise. More is described in The Anxiety-Free Child Program . Medication is another option in attempt to correct biological imbalances in the brain. It should however be the last line of defense, because you can correct biological imbalances in your brain simply by increasing your level of health and well-being.

1) Physiology of Panic Attack in Children and Adults

Panic is an extreme version of a normal response of the body to a threat. This is also known as the fight or flight reaction, first described by Walter Cannon. It is a built-in mechanism which enables humans and animals to mobilize all available energy in the body in order to cope with predators or other life-threatening situations. This alarm reaction is very useful in situations that are realistically dangerous. Some of us though experience this response also in situations that are psychologically dangerous. An argument with your husband or wife or public speaking event can cause this response, because you perceive it as threatening, even though is poses no risk to your survival.

In the case of panic attack, you may perceive no threat at all. The reaction may come out of the blue, without any reason. Somehow, the normal fight or flight reaction has gone wrong. The fact, that your body reacts with a fight or flight reaction to a situation which poses no realistic danger, suggests that the brain mechanisms that control the fight or flight response are not functioning properly.

Your nervous system completes two types of actions: voluntary and involuntary. Voluntary system obeys your direct commands, such as muscle movements and involuntary regulates automatic functions, such as heartbeat, breathing or digestion.

The involuntary system divides into two further branches: the sympathetic and parasympathetic nervous system:

The sympathetic nervous system controls reactions related to emotions and quick reactions.
The parasympathetic nervous system maintains normal functioning of the body in the restful periods.
For a better explanation, imagine the sympathetic system as an accelerator and the parasympathetic system as a brake. The sympathetic system actions in situations requiring quick responses and the parasympathetic system actions in situations not requiring quick response, such as salivation, urination, digestion, lacrimation (production of tears), defecation.

During the panic attack, your sympathetic nervous system sets off release of adrenalin. Adrenalin causes your heart to race, your breathing speeds up, you start sweating, trembling and you get cold hands and feet and all this happens within seconds. Also your sympathetic nervous system causes your muscles to contract, which can be observed in animals when they “freeze in fear”. Humans may experience difficulty breathing due to contractions of muscles in the throat or chest. The digestion is inhibited, excess of stomach acid is released, the liver release stored-up sugar, spleen releases red blood cells, which carry oxygen and therefore enable your muscles to work hard for longer (in case you need to fight or run for your life). Metabolic rate increases and pupils are dilated.

All these reactions of the body happen also when we feel excited, but in a lesser degree. During the panic attack, you can decide to “ride out” these symptoms and they will subside within minutes. By breathing calmly and making calming statements to yourself, you can learn to manage these situations. Adrenalin will be reabsorbed by the liver and kidneys and your body will return to normal.

2) Panic Attacks in Children and Adults

A brain is a very complex and complicated organ in the body. It consists of brain cells called neurons. Neurons transmit nerve impulses between themselves and the space, where the exchange of an impulse or an information between two neurons happens is called synapse. A nerve impulse is transmitted from one cell to another by a chemical reaction. A very small amount of chemicals called neurotransmitters released into synapse enable the transmission of a nerve impulse from one neuron to another.

There are several systems in the brain that are specifically sensitive to a specific neurotransmitter. The serotogenic system for example consists of neurons sensitive specifically to neurotransmitter serotonin.
The serotogenic system has receptor sites in several structures of the brain and some of these structures
are activated during a panic attack. A structure called amygdala is believed to play a key role in instigating panic attacks. Research shows that the amygdala acts together with other structures that contribute to stimulating panic. These structures interpret information as a safe or dangerous. Such information is then stored in memory in hippocampus.

The Amygdala Stimulates These Brain Structures During Panic Attack in Children and Adults:

• Locus coeruleus – responsible for general behavioral arousal
• Hypothalamus – regulates the release of adrenalin
• Periaqueductal grey region – stimulates defensive and avoidance behavior
• Parabrachial nucleus – stimulates rapid breathing

Panic attacks in children and adults can occur when all these structures are overly sensitized. Thus the biological basis for panic attacks is not chemical imbalances, but an overly sensitized system in your brain. Scientists believe that the lack of neurotransmitter serotonin and norepinephrine in the brain contribute to insufficient inhibition of the amygdala. And that is why you may be prescribed medication called SSRI or antidepressants, which increase levels of serotonin in your brain.

What is the cause of the over-sensitization of the system in the brain is unclear. One theory says that acute stress or repetitive stress can cause changes in the system in the brain. If this theory turns out to be true, then the best and most effective treatment for panic disorder would be a program for stress reduction. Medications can help short term, but lifestyle changes need to be made in order to achieve long term results, otherwise symptoms of panic attacks in children and adults will return once medications are withdrawn.

3) Generalized Anxiety Disorder in Children and Adults

One system in the brain, called the gamma-aminobutryic acid system (GABA for short), functions as a neurotransmitter, which is responsible for decreasing brain activity, particularly in the center for emotions called the limbic centre. GABA system acts as a natural calming response. Medication containing GABA or medication that increases level of activity of GABA in the body decreases the level of anxiety in children.
Medication that increases activity of the GABA system is called benzodiazepines. Examples of brand names of common benzodiazepines are Xanax or Klonopin.

Children with anxiety suffer with one of the following deficiencies: the GABA system is either not working efficiently enough or there is lack of the gamma-aminobutryic acid in the body. Another theory explains there may be too many GABA receptors relative to the amount of the GABA neurotransmitters available. None of these theories has been researched sufficiently and also we need to remember that except of the GABA system, there are other systems that contribute to anxiety control (e.g. serotonin system). The gamma-aminobutryic system plays a major role in the explanation of the biological basis of generalized anxiety disorder in children and adults.

Please take a look at The Anxiety-Free Child Program . It is a recommended program designed for children with anxiety. Anxiety in children is likely to follow them into their adulthood if left untreated.