Firstborn and only children more likely to face anxiety, depression, study finds

Being the eldest sibling or being an only child may be linked to anxiety and depression in kids as young as age 8, according to a new study.

Researchers at Epic, a firm that manages a majority of electronic health records across the United States, studied more than 182,000 children in the U.S. who had a well-child visit at age 8, the age at which children should start being screened for anxiety by their pediatrician, according to guidelines from the U.S. Preventive Services Task Force.

Among the children studied, kids born first among their siblings were 48% more likely to be diagnosed with anxiety and 35% more likely to be diagnosed with depression compared with children born second or later.

Only children, those without any siblings, were 42% more likely to have anxiety and 38% more likely to have depression compared with children with siblings.

Researchers did not draw any conclusions as to why firstborn and only children are more likely to be diagnosed with anxiety and depression.

The study's findings come amid warnings of a growing mental health crisis among young people.

In 2021, U.S. Surgeon General Dr. Vivek H. Murthy issued a 53-page advisory warning that the challenges faced by young people are having a "devastating" effect on their mental health.

That same year, the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry and the Children's Hospital Association -- which collectively represent over 77,000 physicians and over 200 children's hospitals -- declared children's mental health challenges amid the pandemic a "national emergency."

In its recommendation in 2022 that kids be screened for anxiety starting at age 8, U.S. Preventive Services Task Force noted that nearly 8% of children ages 3 to 17 had a current anxiety disorder, and that kids under age 18 who have anxiety disorders have an "increased likelihood of a future anxiety disorder or depression."

Anxiety is the feeling evoked when someone experiences fear of something bad happening. It can lead to avoidance, panic attacks, excessive worrying or other symptoms. Anyone can have anxiety at times, but when anxiety symptoms become overwhelming to the point that they consistently interfere with daily life, it can be an anxiety disorder, according to the National Institute of Mental Health.

Like most mental health conditions, anxiety falls on a spectrum, with differing degrees of severity.

In children, symptoms of anxiety may include interruptions in sleeping patterns or difficulty sleeping and excessive emotions in terms of anger, irritability and clingy behaviors. Kids may also demonstrate physical symptoms like an upset stomach or a headache.

Treatment for anxiety is available and may include things like child therapy and family therapy. Maintaining a healthy lifestyle by eating well, being physically active and getting adequate sleep can also help the symptoms of anxiety, according to the U.S. Centers for Disease Control and Prevention.