Is Your Child’s Worry More Than Just a Phase? Recognize the Signs of Anxiety
Anxiety in children and teenagers is the most common mental health problem reported for all age groups.
Studies have estimated that between 5 and 10 per cent of children and teenagers meet the criteria for a diagnosis of anxiety disorder.
Managing emotion, particularly worry and anxiety, is a skill which we develop as we mature.
Young children, in particular, need a lot of help with this.
Some Anxiety is Normal
Feeling anxious sometimes is normal and healthy. We all need a certain amount of anxiety to spur us on and motivate us.
Imagine if we didn’t worry about what our boss said if we didn’t turn up for work.
Or if we didn’t care enough to check whether there is a car coming before we cross the road!
Anxiety can keep us safe. It actually helps to enhance performance.
Sometimes fears and worries get too big and feel out of control though.
If your child’s anxiety is having a significant impact on their day-to-day functioning, it’s a sign that their anxiety may not be serving them at the moment and they may need some support.
Child Anxiety: What to Look Out For
Anxiety affects us in four main ways – the way we feel, the way we think, the way our body works and the way we behave.
This is at the centre of a type of talking therapy clinical psychologists use, called ‘Cognitive Behavioural Therapy’ (CBT).
CBT is a psychological approach which helps children, young people and adults overcome issues including anxiety and low mood. We will come back to that later.
For now, let’s use the four areas to identify signs of anxiety in your child and think about whether they need extra help.
Emotional Signs of Anxiety
Frequent Worrying or Fear
Children with anxiety often experience frequent worrying or fear, which they might express or suppress depending on their coping mechanisms.
This worry is rooted in the brain’s fight-or-flight response, where the amygdala perceives even minor situations as threats.
For some children, this shows itself as constant verbalization of their fears. Others may suppress their feelings, leading to internal distress. Suppression can create a vicious cycle where unexpressed anxiety intensifies, and this can even lead to physical symptoms like headaches or stomach aches.
Sudden Mood Swings
Sudden mood swings are another hallmark of anxiety in children.
These emotional fluctuations stem from the brain’s dysregulated response to stress. It happens when the prefrontal cortex (responsible for regulating emotions) struggles to manage the amygdala’s heightened fear response. The prefrontal cortex is under-developed in children and teens and doesn’t yet and strong connections with the emotion centre of the brain.
As a result, your child may shift rapidly from seemingly calm to irritable or tearful without an apparent trigger.
This instability is often misunderstood as moodiness but may signal underlying anxiety, especially if mood swings are frequent and intense.
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Cognitive Symptoms to Watch For (Thinking-Related Symptoms)
Overthinking and Catastrophizing
Children with anxiety often experience overthinking, where their thoughts spiral into worst-case scenarios, a process known as catastrophizing.
This happens because their brain is on high alert, so they see potential danger everywhere.
These anxious thoughts can become overwhelming, affecting children’s ability to enjoy daily activities, interact socially, and focus on learning at school.
The constant mental chatter can also lead to fatigue and a sense of being trapped in their own mind.
Difficulty Concentrating
Anxiety can significantly impact a child’s ability to concentrate. The brain’s prefrontal cortex, responsible for focus, planning and decision-making, stops working effectively when the body and brain are in “survival mode” (fight or flight).
Highly anxious children find it hard to pay attention in school or during activities they usually enjoy. They may fall behind academically, not because of a lack of ability, but because their mind is preoccupied with anxious thoughts, making it difficult to stay present and engaged.
Physical Manifestations of Anxiety
Stomach Aches and Headaches
Anxiety often presents as physical pains or discomfort.
When a child feels anxious, the body releases stress hormones like cortisol and adrenaline. These hormones prepare the body for “fight or flight” by redirecting blood flow away from the digestive system toward muscles and the brain. This reduced blood flow can slow digestion, leading to discomfort, cramping, or nausea.
On top of this, the gut is highly sensitive to emotional states because of the gut-brain axis, which is the communication network linking the brain and digestive system. This connection explains why emotional distress can directly affect the stomach, causing pain or discomfort.
Headaches are another common symptom of anxiety, often caused by muscle tension and stress. When a child feels anxious, their muscles, especially in the neck and shoulders, can tighten up, leading to tension headaches. Stress hormones like cortisol can also raise blood pressure, which can trigger headaches.
Sleep Disturbances
Anxiety can also disrupt a child’s sleep patterns.
When a child is anxious, their brain remains active and alert, making it difficult to relax enough to fall asleep.
The constant stream of thoughts can lead to difficulty falling asleep, frequent waking, or nightmares. Poor sleep can then exacerbate anxiety, creating a cycle that’s hard to break.
The lack of restful sleep can also impact a child’s mood, concentration, and overall wellbeing, further intensifying their anxiety symptoms.
Behavioural Clues
Avoidance of Certain Situations
Children with anxiety often avoid situations that trigger their fears or discomfort. This avoidance behaviour is a way to prevent the intense feelings of anxiety that these situations provoke.
While avoidance may offer temporary relief, it often strengthens the anxiety over time, making it harder for the child to face their fears in the future.
Increased Irritability or Anger
Anxiety also regularly shows up as as increased irritability or anger in children.
When the brain is constantly on high alert due to anxiety, it can lead to emotional exhaustion. This heightened state of stress makes it difficult for children to regulate their emotions, causing them to become more easily frustrated or angry.
What Can You Do As A Parent to Help With Your Child’s Anxiety?
As a parent, understanding how to support your child through anxiety is crucial.
If you have spotted signs and symptoms in several of the categories above, this has been going on for several weeks or months, and you do not see signs of improvement, then it’s time to take action.
While anxiety can be overwhelming, there are practical strategies you can use to help your child manage their anxiety and build their resilience.
Here are some strategies to try, and some information about when to seek professional help.
1. Help Your Child Notice the Signs in the Body
Children need to understand and ‘tune in’ to their own experiences of the fight or flight response and describe what they actually feel inside their bodies.
As they become more aware of the symptoms of anxiety they can see them for what they really are.
Symptoms of worry and anxiety in children & teenagers can often be misinterpreted as further reasons for worry (eg ‘My tummy hurts – something is wrong with me!’).
As we become more skilled at spotting the signs that our threat system has been activated, we also have a better chance of being able to ‘nip the worry in the bud’ before it starts to take control.
2. Encourage Your Child Not to Avoid Situations They Find Scary
It is natural for anxious children to want to avoid things.
Why wouldn’t you avoid a situation if you knew it was going to make you feel uncomfortable and distressed?
However, avoidance fuels anxiety and keeps it alive.
If children continue to avoid the situations they feel worried about they never give themselves the opportunity to prove that they can cope.
3. Teach Your Child Some Simple Coping Skills
When worries trigger anxiety in children and teenagers, there are some “anxiety hacks” they can use to switch on the more calming system in their body – the parasympathetic nervous system.
They will feel more comfortable and relaxed as a result.
The most important of these is slow breathing.
Children and young people with anxiety will notice that their breathing speeds up when they are anxious. This is part of the fight or flight response to help get more oxygen into the body.
By deliberately slowing the breathing, ensuring your child breathes into their diaphragm (deep in their tummy rather than into the chest), this signals to the nervous system that actually, they are safe.
Practise breathing with them: In for 5 seconds and out for 5 seconds. Practise with your child or young person for at least 5 minutes every day.
Soon it will become more natural for them as a response to anxiety. Whenever they notice their breathing speeds up, they will think “okay, I need to slow my breathing down”.
If you would like more strategies to deal with panic, this article will help.
4. Seek Professional Help
If their anxiety is impacting their everyday life significantly, you should seek professional support for your child. Start by talking it though with your doctor. Your child’s school may also be able to make a referral.
Cognitive Behavioural Therapy (CBT) is an evidence-based approach and I highly recommend it for anxious children if they are around 9 years old or above. For younger children, it can still be effective but parental involvement will be much higher and the therapist will focus on behaviours rather than thoughts.
CBT is based on the idea that how we think (cognitions), how we feel (emotions and bodily sensations) and how we act (behaviour) all interact with each other.
Negative or difficult thoughts cause us distress and make us worry.
Often the worry we have is not in proportion, or realistic to the situation.
CBT is about gently adapting problematic thoughts but also focuses on altering behaviours, which in turn positively impacts thinking patterns.
For example, if a child avoids situations due to anxiety, CBT helps them gradually face these situations through exposure, reducing the fear associated with them.
This behavioural change can lead to a decrease in unhelpful thoughts and emotional distress.
Related Articles
Child Mental Health: The Lifestyle Connection
Adult and Child Mental Health: Supporting Yourself and Your Child
34 Inspirational Quotes for Anxiety Sufferers
How to Deal with Morning Anxiety in Children
Separation Anxiety in Teenagers: 8 Clear Steps for Parents
Phobias: Supporting Your Child
Helping Your Child Cope With Worry
Dr Lucy Russell is a UK clinical psychologist who works with children and families. Her work involves both therapeutic support and autism assessments. She is the Clinical Director of Everlief Child Psychology, and also worked in the National Health Service for many years. In 2019 Lucy launched They Are The Future, a support website for parents of school-aged children.
Through TATF Lucy is passionate about giving practical, manageable strategies to parents and children who may otherwise struggle to find the support they need.
Lucy is a mum to two teenage children. She lives in Buckinghamshire with her husband, children, rescue dog and three rescue cats. She enjoys caravanning and outdoor living, singing and musical theatre.
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