5 Most Common Signs of Anxiety in Children

All parents tend to worry about their children. Sometimes those worries can be about how much their children worry. You might ask yourself things like: Is it normal for her to cry at the thought of being away from me? When will he stop being afraid of the dark? How can I help my child feel less afraid?

We all worry from time to time. Even little kids can be nervous without it being a sign of an anxiety disorder. However, if your child is constantly anxious or exhibits excessive fear, there could be something deeper going on. In this blog post, I’ll shed light on some of the most common child anxiety symptoms to look out for. Plus, I share some of my favorite tips for helping your child cope–including strategies I give my own therapy clients. 

What is childhood anxiety?

Most kids have fears. Sometimes these are developmentally normal, and sometimes they're something different. Many children are afraid of the dark, but some can't be soothed even when a parent is with them or there's a nightlight on. It's normal for toddlers to cling to parents, but school age children typically only struggle for a few days and then are able to separate from parents easily. A lot of people, including children, do not like spiders. So what makes a fear turn into something more?

According to the Center for Disease Control (CDC), childhood anxiety occurs "when a child does not outgrow the fears and worries that are typical in young children, or when there are so many fears and worries that they interfere with school, home, or play activities..." Essentially, if the child's life is negatively impacted by extreme fear, then it's possible that they have an anxiety disorder.

Anxiety disorders are the most common mental health condition in children. According to the Anxiety Disorders Association of America (ADAA), 1 in 8 children had an anxiety disorder in 2014. And since the Covid-19 pandemic, anxiety has been on the rise. One review of 29 studies on childhood anxiety estimates that as of 2021, it's closer to 1 in 4 children. There's several different forms of childhood anxiety disorders. Common anxiety disorders in children include:

• Specific phobias (e.g. arachnophobia, or the fear of spiders)

• Social Anxiety Disorder (previously known as Social Phobia)

• Separation Anxiety Disorder

• Panic Disorder

• Generalized Anxiety Disorder

Other anxiety disorders in children that might be less common include:

• Agoraphobia (fear of environments that might cause panic, helplessness, or embarrassment)

• Selective Mutism

If you'd like specific information on any of these mental health conditions, you can read more about each of them on my Anxiety Therapy page.

There are also some mental health conditions that may be associated with anxiety, but aren't actually anxiety disorders. Obsessive compulsive disorder and post-traumatic stress disorder (PTSD) used to be classified as an anxiety disorders in previous versions of the DSM, but the DSM-5 separated them into their own categories. Children with obsessive compulsive disorder also experience intense anxiety related to certain thoughts or actions, but the difference is that they are compelled to do something in response. For example, children who are worried about germs or illness may wash their hands after they touch anything, regardless whether or not it's dirty. Similarly, children who have experienced trauma might have post-traumatic stress disorder (PTSD) and experience symptoms of anxiety when reminded of the traumatic event. However, there usually isn't a specific memory that causes anxiety, but rather a broader situation that triggers worry.

What causes childhood anxiety?

Many different things might contribute to a child developing anxiety. The specific combination of factors is possibly different for every single person with anxiety. However, like most mental health conditions, it comes down to a combination of nature and nurture. We know that if a close relative has an anxiety or depressive disorder then it's more likely that a child might develop anxiety. As of 2015, it's estimated that 30-40% of the underlying causes for anxiety are genetic. For parents with anxiety, this doesn't mean that you "caused" it! It is important to remember that half of children with anxiety disorders do not have a parent with an anxiety disorder. Environmental factors are just as important if not more important than genetic ones. Negative life events, academic pressure, and peer relationships are all environmental factors that may contribute to anxious symptoms.

Though it does not cause anxiety, there is significant overlap between anxiety disorders and attention deficit/hyperactivity disorder (ADHD). ADHD and anxiety disorders co-occur with each other 25% of the time. Some of the symptoms do overlap, including difficulty concentrating and restlessness, but not everyone who has ADHD has anxiety or vice versa. Although ADHD has been historically under diagnosed in those assigned female at birth because they often have predominantly inattentive symptoms, recent research has shown that females with ADHD are more likely to also have an anxiety disorder.

5 common symptoms of anxiety in children

The symptoms of anxiety in children can differ based on what type of anxiety disorder they have. A child with panic disorder will have a panic attack seemingly at random, while a child with social anxiety disorder will seem like a totally different person when around caregivers than with others. A child with generalized anxiety disorder can have a lot of different worries constantly, while a child with separation anxiety disorder is fine when around family members but experiences intense fear if they're out of sight. Regardless of what type your child might have, there are some common symptoms that occur across different types of anxiety. Here are some common symptoms that children with anxiety might experience:

Physical Symptoms

Many people do experience physical sensations alongside their emotions as part of the body's normal response. You might know the phrase "butterflies in your stomach" for when you're nervous about something. Your child might also have heard it, but that doesn't mean they understand it. Young children are very concrete and are still learning how to recognize and talk about what they feel. The closest experience children have to this sensation is usually a stomachache. That might be why according to one study, 70% of children with anxiety reported having stomachaches. Other physical symptoms that can be signs of anxiety in children include restlessness, fast heartbeat, muscle tension, trouble breathing, feeling dizzy, sweating, and trouble sleeping.

Being "On Guard"

Children with anxiety are often hypervigilant or "on edge." This means that they are constantly aware of and scanning their environment for danger. They're also more likely than non-anxious children to believe things around them are actually threatening. For example, they may have an exaggerated startle response, such as jumping at noises that other children do not.

Disliking Unexpected Changes

Many children like knowing what is going to happen throughout the day. But for some children, unexpected changes, even if they seem like something the child would enjoy, can be a big challenge. Oftentimes, the child sees these changes as something that they are not prepared for and ask repeated questions about the change and why it is happening. They might even stall, refuse, cry, or otherwise avoid the change.

Avoidance

It will be different depending on the focus of the fear, but the primary way that children cope with anxiety is to avoid it, or at least try to. For children with separation anxiety, this can be why they take so long to get ready for school or bed—they're avoiding separating from parent. For children with general anxiety, they may be so scared of making a mistake that they procrastinate on homework or not turn it in even if they did finish it.

Extreme Distress

When attempts to avoid fears don't work, children may react in a way that seems disproportionate to the situation. While it may seem like these disruptive behaviors are out of nowhere, they are usually in response to certain situations. For children with separation anxiety, going to school represents a major separation, but so does sleeping in their own bed. The separation itself is the reason that a child might cling, negotiate, cry, whine, repeat questions, or request reassurance several times in seemingly different situations.

A child with anxiety may not have every single symptom listed, but if your child has several, then you might consider talking to your child's pediatrician or a mental health professional to determine if your child might be dealing with an anxiety disorder. Feeling anxious is a normal part of life, but your child and your family don't have to feel anxious all the time. You and your child deserve a safe and supportive space to learn how to manage your child's anxiety more effectively and get back to daily life.

Supporting your anxious child

It can be hard for parents to know what to do when a child is anxious. You want to be compassionate, but you can't let your child avoid their fears forever. In fact, kids learn that they cannot manage fears independently if parents consistently do not provide autonomy to the child to face their fears. There is also limited research into the long-term effects of medication on anxiety symptoms in children. So what can parents do to help their children when they feel anxious?

• Don't ignore the feeling, but don't empower it either. If a child is scared, acknowledge the fear and tell them that it is okay to feel afraid, and you're going to help them figure out how to face it.

• Provide encouragement, not promises. You can't promise that everything will be fine, because sometimes it won't be. There are always going to be challenges in everyone's life. But you can provide encouragement that whatever happens, you believe that they will be able to cope with it. Offer choices of things that might be helpful, like hugging a favorite stuffed animal or talking about what's worrying them.

• Show them adults worry too, and that there are ways to handle it. Children may think that adults have it all figured out, and that they never worry. This can mean that they don't want to acknowledge their fears, but it's important to show them that these are feelings everyone copes with. You might say something like "I'm worried about a big presentation I have to give at work today, and I'm going to remind myself to take deep, calm breaths beforehand to help me get through it."

• Co-regulate, especially with younger children. A child's ability to cope, especially in early years, requires some help. No one just learns how to regulate and use coping skills one day on their own. People learn how to regulate themselves based on others. For parents, this means trying to be as consistent in your responses to your child as possible, labeling and talking about feelings, and providing physical and emotional comfort when child is distressed or dysregulated.

You want to do everything you can to help your child, and sometimes that may mean asking for help, and that is okay. If you think your child might have an anxiety disorder, it can be helpful to seek professional help. I am a Licensed Professional Counselor in the Dallas, Texas area that specializes in working with children and adolescents with anxiety. If you're interested in my child therapy services, you can learn more here or reach out to schedule a free 15 minute phone consultation to see if I am a good fit for your child's and your family's needs.