"Excessive worries about dirt, germs or other dangers; may repeat same questions over and over or constantly seek reassurance"

"Child tries to stop worrying but can't control the anxiety; worries interfere with friends, school or home life"

"Obsessive-compulsive symptoms for more than an hour each day; experiences symptoms as unwanted and intrusive"

"Exhibits least one physical symptom, such as restlessness, feeling keyed up or "on edge;" fatigue; difficulty concentrating; irritability; muscle tension; or sleep problems"

"Has physical symptoms of anxiety (sweating, blushing, racing heart, trembling) when confronted with certain social situations"

" When her oldest daughter starting having headaches, stomachaches, and lost interest in favorite activities, her mother was concerned that the eight-year-old had a serious physical problem."

"All I saw were the physical symptoms and the radical changes in her behavior," says Debbie P, whose daughter was eventually diagnosed with depression and generalized anxiety disorder (GAD). "All the acting out at school, the refusal to compete in soccer, the sleeping problems.I didn't know how much she was worrying and how anxious and depressed she really was." "

""Kids often suffer in silence with anxiety disorders," says Susan Swedo, M.D, Chief, Pediatrics and Development Neuropsychiatry Branch, National Institute of Mental Health (NIMH)."

"Many children have some apprehension or fear about growing up-separating from parents, developing peer relationships, and attending school."

"However, for a substantial group of children, anxiety about some of these issues becomes severe and long-lasting enough to affect a child's ability to conduct daily activities, perform in school or develop relationships. "

""Anxiety disorders are among the most common psychiatric disorder in kids and often cause tremendous emotional pain and disruption of family life," says Daniel S. Pine, M.D., Chief, Section on Developmental and Affective Neuroscience, NIMH. "And we know that childhood anxiety disorders, if left untreated, can set the stage for more serious psychiatric illness in adolescence and adulthood." "

"As many as one in eight children aged 9-17 may suffer from an anxiety disorder each year, according to the U.S. Surgeon General (see table)."

"Some studies also indicate that, as the child gets older, these disorders may follow a "developmental progression" from one anxiety disorder into another and from an anxiety to an affective disorder."

"As in adults, anxiety disorders in youngsters co-occur with other psychiatric disorders. Up to three-quarters of children with an anxiety disorder suffer from another anxiety disorder or depression."

"GAD in youngsters co-occurs the most frequently with other disorders; about one-half to three-quarters of children with GAD also have depression or another anxiety disorder such as separation anxiety disorder. Anxiety disorders may also co-occur with attention deficit hyperactivity disorder (ADHD) and Tourette's Syndrome."

""Anxiety becomes a disorder when there's a mismatch between the inherent threat of a situation and the child's physical or emotional response that results in either suffering or impairment."

"Many different things can influence that response, from brain chemistry to personality to things in the environment. " "

"Gender, age and family history are known to influence the likelihood of developing an anxiety disorder."

"Girls have higher rates of anxiety disorders than boys, a relationship that holds up into adulthood."

"Different anxiety disorders also show up at different ages, with separation anxiety disorder common in very young children, social anxiety disorder beginning in early adolescence, and panic disorder in later adolescence and early adulthood."

""Having a parent with an anxiety disorder increases the chances of having a child with an anxiety disorder," says Kathleen Merikangas, Chief, Section on Developmental Genetic Epidemiology, NIMH."

""For all anxiety disorders taken together, a child whose parent has an anxiety disorder is three-and-a-half times more likely also to have an anxiety disorder than a child whose parent does not have one," she says."

"For example, about one in four children with obsessive compulsive disorder (OCD) has a family member with OCD; almost all the remaining three-quarters have a relative with another anxiety disorder or an affective disorder."

"For example, temperament may affect how sensitive a child is to new situations or stimuli and whether a child misinterprets
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