Internalizing symptoms in a child deserve professional evaluation when they do not respond sufficiently to support from parents, members of the extended family, teachers, or friends. Although depressive or anxious symptoms can signal the presence of a primary anxiety or depressive disorder, they are most often seen in the therapist's regular office practice as a result of circumscribed reactions to environmental stresses, developmental challenges, or familial conflicts that overwhelm the coping resources of the child. As a result, therapists will find that internalizing symptoms, whether anxiety or depression, frequently accompany children's presenting problems.