Growing up with a knot in your stomach: a childhood with anxiety and depression

Barcelona"I felt very different from everyone else. I felt weak at school and developed anxiety and a lot of sadness," explains Mireia, now 23, who recalls managing anxiety and depression during adolescence. "I stayed in class, didn't go out to the playground, arrived late, and didn't feel like talking to my friends. Everything seemed normal, but internally I was unwell and I became isolated," she says about the anxiety attacks that appeared when she was fourteen and which she couldn't verbalize until she was sixteen. Although anxiety and depression are socially associated with adulthood, this reality also exists among children: it is estimated that between 10% and 20% of children and adolescents may have an anxiety disorder, according to the [unclear - possibly "warning" or "warning"]. Itersia Psychotherapy Center.

When mental health is also a matter for children

This figure isn't just a statistic; it represents real people. In Berta's case, the family began to suspect something was wrong when, on Sunday afternoons, the nine-year-old girl started experiencing recurring stomach aches in anticipation of starting school the next day. "At first, you don't think much of it because you assume it's just laziness, until one day she couldn't even get into school. She was completely paralyzed; the situation escalated until it became unbearable, and she missed weeks of school," explains Antonio Joaquín Serrano, Berta's father. In both Mireia's and Berta's cases, the anxiety was focused on the school environment. "When we dropped her off at school, she felt alone and attributed it to anxiety, but in reality, it all stemmed from the separation her mother and I were going through, which she hadn't been able to handle emotionally," Antonio comments.

In Mireia's case, the academic pressure overwhelmed her: "Anything that involved taking exams made me feel terrible. Anxiety would grip me before and during the exam, and I couldn't cope. I felt like the grade would define me as a person; I was so afraid of failing that I would explode." Although her family wasn't strict about grades, she experienced it as a failure because of her own pursuit of excellence. As the anxiety became more pronounced, feelings of sadness also emerged, leading to depression.

Anxiety and depression: two sides of the same coin

This pack Emotional distress is what experts call comorbidity. "Anxiety and depression often go hand in hand because they belong to the same sphere; the simultaneous presence of several symptoms in children under ten is high," explains Laia Mollà, a psychologist specializing in clinical psychology and an assistant in the Mental Health Area of ​​Sant Joan de Déu Hospital. In Mireia's case, it was a gradual process: "I started with anxiety, then I lived with both symptoms, and towards the end, I remember being more depressed: I was exhausted, with no desire to do anything, and very negative thoughts."

The depression lasted longer than the anxiety, while those around them failed to grasp the seriousness of the situation. "In general, girls exhibit more 'internalized' symptoms (sadness and fear), while boys exhibit more 'externalized' symptoms (irritability, anger, behavioral problems). Often, depression in a child manifests as constant anger or more frequent tantrums, rather than crying in their room," explains Mollà.

When fear stops protecting

"Fear is normal and adaptive: it alerts us to danger and helps us adapt to our environment. The problem arises when it's disproportionate to the degree of the threat or when it appears in response to stimuli that aren't actually dangerous," explains Dr. Mollà. For example, it's normal to be nervous before a presentation, but if that fear prevents the child from sleeping or paralyzes them, then it's anxiety. Anxiety in children can manifest in multiple ways that often overlap. According to San Juan de Dios Hospital, The most frequent is specific phobia (19.3%), an excessive fear of specific stimuli such as animals, the natural environment, or situations like school. This is followed by social phobia (9.1%), in which the child suffers in the presence of social situations due to fear of ridicule or criticism, and separation anxiety disorder (SAD) (7.6%), which generates distress in the absence of caregivers and fear that something will happen to them.

With a lower prevalence but a profound impact, there is post-traumatic stress disorder (5%), which arises after experiencing traumatic events, and panic disorder (2.3%), characterized by sudden and unexpected anxiety attacks. Finally, generalized anxiety disorder (GAD) (2.2%) causes constant worry about all kinds of everyday issues—often accompanied by irritability and sleep disturbances—while health anxiety leads to obsessive and compulsive behaviors due to the fear of becoming ill.

"Fears are linked to cognitive maturity," explains Dr. Mollà. While young children have more "egocentric" fears (animals, darkness, monsters, death), in adolescence these fears become relational: fears about identity or the opinions of others. "Fear is very primitive and irrational; no matter how much you are told there is no danger, the feeling doesn't go away easily," she adds.

The danger of minimization

"When you're little, you don't know how to explain what's wrong. I remember stomach aches, biting my nails, scratching my hands a lot and making cuts. I was also very sleepy all day, a kind of lethargy brought on by the discomfort itself," explains Mireia. At that time, she was passing her exams, and at home, they didn't feel like anything was wrong. However, when she started high school, she began to fail. "That fueled my fear even more. I couldn't listen in class, I couldn't sleep, I was blocked, and my family noticed, not so much because of the anxiety as because of the sadness. It got to the point where I didn't want to get out of bed anymore," she explains.

In Berta's case, Antonio recognized the signs because he himself had suffered from anxiety as a child. "I suffered a lot. As a parent, you think, 'I went through the same thing, and I had a really hard time. It's an unpleasant situation, full of fear, of being completely blocked,'" recalls Antonio, who now heads the association. From personal experience, dedicated to fighting the stigma of mental health.

The barrier of silence and mistrust

When adults noticed this situation, Mireia felt her fears were being minimized. "A teacher told me it was just teenage stuff. The fact that I didn't feel heard made me stop talking about it." This feeling of being misunderstood is directly reflected in the data. According to the latest UNICEF Opinion Barometer (2024)Silence is the most common response among young people: more than 50% of teenagers who identify a mental health problem do not seek help. 67.6% do not tell their families so as not to worry them, and more than half (56%) do not trust their teachers or counselors to talk about it.

This breakdown of trust with the adult environment means that one in three young people go through their distress in complete isolation. "I didn't want to share it because I didn't know how to explain it, because I thought no one would understand me or that they would judge me. I was ashamed of feeling different," confesses Mireia.

Detecting it early prevents it from becoming chronic.

Despite the barrier of silence, school and family remain fundamental spaces for uncovering these kinds of problems. "Children often don't know how to explain what's wrong with them; we have to be attentive, observe, and above all, normalize and empathize. We shouldn't pretend nothing is happening; we must help them put words to what they feel. The more emotional skills they have, the more tools they'll have in the future. It's also key that we, the adults, teach them our strategies," says Juan de Dios.

According to Antonio's experience at the Association, in many cases schools and institutes lack sufficient psychological counselors. "They are the first step in helping children, if they detect the problem and provide the reassurance needed to reduce tension. The subsequent work of professionals will follow. Although things are improving, there is a lack of resources, more professionals, and a general lack of emotional awareness," he comments. During the years he has been part ofFrom Personal ExperienceShe has noticed an increase in cases of anxiety and depression in children and young people: "In secondary school workshops, in groups of thirty students, there are about five or six with problems of anxiety, depression or self-harm. The volume has intensified enormously," she warns.

The right to put oneself first

"It's very important to observe whether there is disproportionate suffering. The more chronic a symptom becomes, the harder it is to modify later," the psychologist explains. The path to mental health in children and young people is not easy, and it still feels as if these ailments belong solely to the adult sphere.

Today, Mireia looks back with the perspective that time and therapy provide. "It was very difficult for me to separate my identity from the anxiety and sadness, because for many years I felt that I was my disorder, but it helped me grow as a person and change things about myself that I didn't like," she says. Berta, now fourteen, recently told her father, "From now on, I'm going to be selfish with my mental health," a statement Antonio celebrated as a victory. Throughout this journey, Mireia has learned a great deal. "I wish someone had told me I wasn't crazy, that what I felt was real, and that I could get through it," she reflects. The challenge, as Antonio reminds us, is for mental health to stop being a whisper in school hallways and become a priority on every family's dinner table. Because detecting an emotional stomachache early can literally change the course of a life.