What is Anxiety in Childhood?
Anxiety in childhood is excessive worry or fear that causes problems in a child’s life.
These worries and fears interfere with a child’s daily activities and relationships. Their overall quality of life can be disrupted.
Children with anxiety may experience feelings of tension, nervousness, and unease. They may also experience somatic symptoms. Some examples of these symptoms include sweating, trembling, and a rapid heartbeat. Others include stomachaches and headaches.
Anxiety can manifest itself in a variety of forms in childhood. Some forms of anxiety include separation anxiety, social anxiety, and generalized anxiety. Other forms include specific phobias, panic attacks, and obsessive-compulsive disorder (OCD). These conditions can affect how a child engages in normal activities. Anxiety can also affect how they interact with peers and perform at school.
Concerned that your child is worried a lot?
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Symptoms of Anxiety and Stress in Children
- Excessive worry or fear: your child is constantly worrying about everyday activities and events
- Difficulty controlling worry and anxiety: your child’s worried and anxious thoughts consume a large part of their day, making it hard for your child to focus
- Always asking “what if”: your child is always thinking about the worst possible scenario and asking what if this happens
- Somatic symptoms: your child complains of having a stomach ache, feeling nauseous, or having a headache
- Difficulty concentrating or paying attention: your child may have trouble focusing due to intrusive thoughts and feelings
- Restless and irritable: your child may have a hard time being still and becomes easily annoyed
- Seeks constant reassurance: your child needs persistent reassurance and validation about everyday activities and events. Your child may repeatedly ask what time band practice is and be overly worried about being late
- Perfectionism and rigid thinking: your child may be trying to do everything right to avoid uncertainty and reduce their anxiety
- Avoidance of activities or situations that trigger anxiety: your child may avoid certain places, people, and experiences as a way to reduce their anxiety
Causes of Anxiety and Stress in Children
Genetics: children may be more likely to experience anxiety if they have a family history of anxiety disorders.
Environmental factors: children who grow up in stressful and chaotic environments may be more prone to anxiety and stress. Some examples include trauma and unpredictable or over-controlling environments. Other factors include exposure to violence or growing up around addition or persistent family discord.
Recent or sudden change: children who go through a recent or sudden change may experience an increase in anxiety and stress. Some examples include a move and starting a new school. Other types of change include loss of a close family member or divorce.
Medical conditions: children with certain medical conditions or chronic illnesses may have anxiety and stress. For example, children with asthma may experience anxiety related to their health.
Parental anxiety: children may be more likely to experience anxiety if their parents are anxious or stressed. This connection can be due to both genetic and environmental factors.
Media exposure: children who are exposed to news or social media coverage of traumatic events or disasters can be stressed.
Learning and social challenges: children with learning disabilities may find that time in the classroom is stressful. Children with autism may struggle with social interaction. These stresses and struggles increase the chances that a child will feel anxious. Anxiety is commonly diagnosed in combination with autism, learning challenges, and ADHD.
Gifted and talented: children who have an IQ in the top 5% of the population are considered gifted and talented. They may be more sensitive and also tend to have an intense intellectual curiosity. These traits may lead them to experience greater rates of anxiety. Gifted children may struggle with overstimulation and emotional intensity. Gifted children may feel pressure to excel and perform at extremely high levels. This can lead to anxiety when they perceive that they are not meeting their own or others’ expectations.
Trauma: children who experience traumatic events can have anxiety either temporarily or for very long periods. Children who experience ‘Big T’ traumas are more likely to experience anxiety. Some examples include natural disasters and wartime. Others include personal tragedy, severe medical complications, or other crises. Other seemingly minor events in childhood, like a move across town, divorce, or change in friends, can also cause anxiety. Psychologists call these ‘Small t’ traumas. They can have a significant impact on a child’s worries and mental health.
What to Do About Anxiety and Stress in Childhood
Normalize the experience of anxiety.
Let your child know that feeling anxious is a normal part of being human. Many people experience anxiety at some point in their lives. This information can help reduce any shame or stigma your child may feel about their anxiety.
Teach your child what happens in their body when worry and anxiety are present.
Learning the physical symptoms of anxiety can help your child manage their anxiety. Help them understand that anxiety and strong emotions may cause their body to activate their stress response system.
Here’s a list of symptoms you could share with your child.
- Dilating pupils
- Cold or sweaty hands
- Tightening in the chest
- Fast heartbeat
- Blood rushing to your muscles
- Tense muscles
You can get into more detail with your child, explaining other sensations they may notice with anxiety. For example, their mind may focus exclusively on one thing, making it hard to pay attention to anything else. Their digestion system may shut down, leaving them with a stomachache. They may have a sinking feeling in their tummy or feel nauseous. They may get a burst of adrenaline and cortisol, which can leave them feeling jittery and on edge to the point of exhaustion. This sensation is sometimes referred to as ‘wired and tired.’ It’s the feeling of stress that is coupled with a feeling of physical depletion.
Teach your child how to cope with anxiety.
Teach your child coping strategies that can help them manage their anxiety. Teach strategies such as deep breathing, progressive muscle relaxation, or positive self-talk. Encourage them to practice these strategies regularly, even when they are not feeling anxious. Take our Cadey course to learn strategies you can teach your child.
Encourage healthy habits, such as exercise.
Help your child develop a healthy routine with regular exercise, a balanced diet, and plenty of sleep. Anxiety and stress activate the autonomic nervous system. Regular exercise can reduce the somatic symptoms your child experiences with anxiety. Research shows regular exercise can be as effective as medication.
Set up a time when your child can talk with you about their anxiety and stress.
Choose a regular time each day when your child can share with you about their worries. It may help to set a timer and give your child your undivided attention if possible. First, listen and validate your child’s concerns. Pick a strategy for managing their concern. Work on listening and validating. Help your child develop their own solution. Some children like to draw out the worry and throw it away. Another strategy to try is to think of the best-case, worst-case, and most likely outcome. If you want to learn more tips about setting up a worry time, take our Cadey course.
Model healthy coping.
Model healthy coping behaviors for your child. Some examples include practicing self-care and taking breaks when needed. Show your child how you seek support from others when you are feeling stressed or anxious. This modeling can help your child learn healthy ways to manage their own anxiety.
Create structures and routines to help with anxiety-provoking situations.
Create and maintain a set schedule. Schedules create predictability and a routine. Knowing what to expect can help your child feel less anxious and more in control. A schedule can also help reduce decision-making for your child. When your child knows what to do and when to do it, they don’t have to make as many choices throughout the day, which can help reduce anxiety. Some things to include in your child’s schedule are a consistent bedtime and wake-up time, a predictable morning routine, and meal time as a family.
When to Seek Help For Anxiety & Stress in Childhood
It is normal for adults and children to experience symptoms of anxiety and stress. An excellent place to start with helping your child is the Cadey course on childhood anxiety. In this course, you learn the tools you need to help your child. If symptoms continue to persist and interfere with your child’s daily life, it is time to see a professional.
If left untreated, childhood anxiety can lead to long-term mental health problems. Some examples of these problems include depression, substance abuse, and social isolation. Therefore, it is important for parents and caregivers to recognize the signs of anxiety in children.
Professional Resources on Anxiety and Stress in Children
It’s important to remember that each child is unique. What may cause anxiety or stress in one child may not affect another in the same way. If your child is feeling significant anxiety or stress, it may be helpful to get support from a professional.
A professional or mental health expert might help you better understand these anxiety symptoms and causes. They can offer a professional evaluation and support.
A mental health professional can also help rule out other kinds of anxiety that are more specific. Some examples include post-traumatic stress disorder, panic disorder, and separation anxiety disorder. A professional may also help rule out a specific phobia or social phobia.
The following professionals could help.
- Psychotherapist or play therapist: to treat anxiety or any other emotional concerns; for a small child 6 and under, play-based therapy may be a good fit. Those 7 and up are more likely to benefit from cognitive behavioral therapy focused on increasing emotional awareness and coping strategies
- School psychologist: to treat anxiety in the school setting; to make accommodations for testing with the teacher and team; to address learning concerns; to look at ways to adjust the setting to lessen anxiety; to meet with your child or a group of children
- Psychologist or neuropsychologist: to consider a full assessment to look at symptoms in a mental health context and get a profile of your child’s strengths and weaknesses as well as recommendations for the next steps
- Psychiatrist or pediatrician: to rule out medical causes, allergies, or conditions like IBS that are impacted by stress and worry but also have a medical cause; to share concerns about anxiety and learn about medical treatments that may be applicable
Similar Conditions to Anxiety
- Somatization: anxiety can have physiological symptoms that accompany excessive worrying; children may be aware of the tummy aches but not attribute them to worry
- Performance or social anxiety: anxiety can occur in situations where a child must perform; this can be related to fears of being on “stage”
- Self-esteem: anxiety can result from low self-concept and may cause is prolonged mental health issues
- Phobias: anxiety can come from an overwhelming fear. Someone who dissolves into tears whenever a dog comes near may have a phobia of dogs
References for Anxiety and Stress in Children
Culbert, Timothy & Kajander, Rebecca. (2007) Be the Boss of Your Stress (Be The Boss Of Your Body®). Foxman (2003). Recognizing anxiety in children and helping them heal.Green, Andi (2011) Don’t Feed The WorryBug.Helsley, Donalisa (2012). The worry glasses: Overcoming anxiety. Huebner, D. (2005). What to do when you worry too much: A kid’s guide to overcoming anxiety.Peters, D.B. (2013). From worrier to warrior: A guide to conquering your fears. Great Potential Press: Tucson, AZ
Books for kids on anxiety
Bender, Janet M (2004). Tyler Tames the Testing Tiger.
Cook, Julia (2012). Wilma jean and the worry machine.
Cook, Julia (2012) Wilma jean and the worry machine: Activity and idea book.
Freeland PhD, Claire A. B. and Toner PhD, Jacqueline B. (2016). What to do When You Feel Too Shy: A Kid’s Guide to Overcoming Social Anxiety
Meiners, Cheri J. (2003). When I Feel Afraid (Learning to Get Along).
Zelinger, Laurie & Zelinger, Jordan (2014). Please explain anxiety to me.
Books for kids on perfectionism
McCumbee, Stephie (2014). Priscilla & the perfect storm.
McDonnell, Patrick (2014). A perfectly messed up story.
Mulcahy, William (2016). Zach makes mistakes.
Pett, Mark & Rubinstein, Gary (2011). The girl who never made mistakes.
Satlzberg, Barney (2010) Beautiful oops!