Be Not Anxious…Conditions That Can Mimic Anxiety in Children and Teens

Welcome to our Summer Blog Series examining the impact of anxiety disorders on church participation and spiritual development in kids. Today, we’ll look at other conditions that can mimic signs and symptoms of anxiety in children and teens.

Common conditions that often result in anxiety symptoms or occur in conjunction with anxiety symptoms are listed below.

Attention-Deficit/Hyperactivity Disorder (ADHD) may mimic symptoms of anxiety, or occur concomitantly with one or more anxiety disorders. Up to 30% of children and 50% of adults with ADHD will also be diagnosed with one or more anxiety disorders.  Kids with ADHD may experience anxiety because of difficulties meeting academic expectations in home or in school. They may experience anxiety in social situations because impatience, impulsivity and poor listening skills lead to rejection by peers, avoidance of such situations by the child and delayed development of age-appropriate social skills.

Children and teens with Asperger’s Disorder or non-verbal learning disorder often present with rigidity, inflexibility and obsessive, perseverative anxiety symptoms. The intense preoccupation seen with specific topics or objects in children with Asperger’s disorder is often mistaken for specific obsessions associated with Obsessive-Compulsive Disorder. They may also exhibit avoidance and withdrawal in social situations, repetitive behaviors and significant social skill deficits.

A child with a specific learning disorder such as dyslexia may become very anxious in school or at church when confronted with the expectation of reading aloud. Kids with unrecognized and untreated learning disorders may exhibit significant anxiety when asked to take tests, begin to evidence school refusal and experience signs of separation anxiety or physical symptoms of anxiety, especially on Sunday evenings or following extended breaks from school.

Some children experience anxiety symptoms that occur only during episodes of another mood disorder, such as Major Depression or Bipolar Disorder.  Kids with depression may experience difficulty sleeping, panic and physical symptoms similar to those seen in anxiety disorders. Some researchers have reported increases in obsessive thinking among youth with Bipolar Disorder experiencing manic episodes, along with restlessness, irritability and insomnia. In such cases, it is important to determine whether symptoms of anxiety were present at times when the child wasn’t experiencing an acute mood disturbance in order to arrive at an accurate diagnosis and prognosis.

Youth experiencing symptoms of a psychotic illness (Schizophrenia, Brief Reactive Psychosis) may evidence severe anxiety associated with paranoid thoughts and altered perceptual experiences along with marked social isolation and withdrawal.  In addition, children who have experienced Post-Traumatic Stress Disorder (PTSD) following significant trauma or abuse may experience marked symptoms of anxiety associated with nightmares, flashbacks and vivid recollections associated with the traumatic event(s).

Anxiety symptoms may also be caused by a variety of medical conditions. Parents should consider having their child seen by their pediatrician or family physician to rule out such potential causes of anxiety, even in situations when mental health intervention is being pursued.  Such conditions include, but are not limited to hyperthyroidism, asthma, seizure disorders, migraine headaches and lead intoxication.

Other prescription medications associated with anxiety-like symptoms include medications prescribed for asthma, guanfacine and atomoxetine. Anxiety is a potential side effect associated with many prescription and over-the-counter medications, including cold medications, antihistamines and diet pills. Energy drinks with high caffeine content are an increasingly popular precipitant to anxiety symptoms among teenagers.

Alternatively, anxiety is a common cause of a variety of physical complaints that result in frequent physician visits and school absence.  When symptoms such as a pounding heartbeat, sweating, shaking, difficulty breathing, chest pain or pressure, fear of choking, nausea, chills or dizziness interfere with a child’s ability to function on a day to day basis and can’t be attributed to a specific medical condition or cause, referral to a mental health professional with appropriate training and experience in assessment and treatment of children with anxiety is appropriate.

About Dr. G

Dr. Stephen Grcevich serves as President and Founder of Key Ministry, a non-profit organization providing free training, consultation, resources and support to help churches serve families of children with disabilities. Dr. Grcevich is a graduate of Northeastern Ohio Medical University (NEOMED), trained in General Psychiatry at the Cleveland Clinic Foundation and in Child and Adolescent Psychiatry at University Hospitals of Cleveland/Case Western Reserve University. He is a faculty member in Child and Adolescent Psychiatry at two medical schools, leads a group practice in suburban Cleveland (Family Center by the Falls), and continues to be involved in research evaluating the safety and effectiveness of medications prescribed to children for ADHD, anxiety and depression. He is a past recipient of the Exemplary Psychiatrist Award from the National Alliance on Mental Illness (NAMI). Dr. Grcevich was recently recognized by Sharecare as one of the top ten online influencers in children’s mental health. His blog for Key Ministry, was ranked fourth among the top 100 children's ministry blogs in 2015 by Ministry to Children.
This entry was posted in Anxiety Disorders, Key Ministry and tagged , , , . Bookmark the permalink.

1 Response to Be Not Anxious…Conditions That Can Mimic Anxiety in Children and Teens

  1. Steve thank you for making these important distinctions! It is SO difficult sometimes to tease these behaviors out and manage them. Seeing it in print like this gives some clarity!


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.