How to tell if your child has anxiety—and what you can do about it

What Is Anxiety in Children?

Anxiety in children is excessive worry or fear that interferes with daily activities, school performance, or social relationships. Unlike normal childhood worries, anxiety disorders cause persistent distress and avoidance behaviors that disrupt a child’s normal development.

Normal anxiety helps your child stay safe—it’s what makes them look both ways before crossing the street. But when anxiety starts controlling their choices, it’s crossed into disorder territory.

For example: normal anxiety is feeling nervous about the first day of school but still getting on the bus. Concerning anxiety is your child faking sick to avoid school or having a meltdown every Sunday night thinking about Monday morning.

Anxiety in children shows up in many different forms. Here are the most common types you might notice:

Separation anxiety: Your child’s fear of being apart from family members. This goes beyond normal clingy phases—we’re talking about intense distress when you leave, even for routine activities.

Social anxiety: Fear of being judged or embarrassed that interferes with friendships, school participation, or activities. Your child might avoid raising their hand in class, refuse to order their own food at restaurants, or skip social events.

Generalized anxiety disorder (GAD): Persistent worry that jumps from topic to topic in more than one setting—school, family, friends, world events. These are the kids who might be described as “old souls” or “worriers,” but their concerns feel overwhelming rather than just thoughtful.

Phobias: Intense, unreasonable fear of specific things—dogs, thunderstorms, elevators, or medical procedures. The fear is so strong it disrupts daily life.

Panic disorder: Sudden, intense episodes of fear that cause physical symptoms like racing heart, trouble breathing, or feeling like something terrible is about to happen. These attacks can be terrifying for both child and parent, as they can often present like medical emergencies.

At What Age Can Childhood Anxiety Begin?

Anxiety disorders can start as early as preschool, with different types typically emerging at different developmental stages.

Research shows that many common anxiety disorders have predictable onset patterns:

• Ages 8 to 13: Phobias, separation anxiety, and social anxiety typically emerge
• Ages 17 to 22: Obsessive-compulsive disorder (OCD) usually develops

Generalized anxiety and panic disorders often start later, though they can affect children too. The key thing to remember: even if a specific disorder isn’t diagnosed until later, symptoms often appear much earlier. Your preschooler’s intense distress about being dropped off at daycare that continues for months rather than weeks—that could be early separation anxiety disorder.

Common Signs of Anxiety in Young Children

Anxiety in children often shows up as behavioral changes or physical symptoms rather than verbal complaints. Some signs are obvious—crying, clinging, expressing specific fears. But many are subtle, and your child may not even understand what they’re feeling.

“Kids will express anxiety in the ways that they can,” says psychologist Tamar Chansky, PhD, a childhood anxiety expert and author of Freeing Your Child from Negative Thinking.

Your child may not have the words to say “I’m anxious about the math test,” but their actions tell the story. Here’s what to watch for:

1. Excessive Worry

We all worry sometimes, but anxiety amplifies those worries into persistent, overwhelming concerns. Watch for kids who ask “what-if” questions constantly, express fears about family, school, friends, or activities, or seem paralyzed by fear of embarrassment or making mistakes.

2. Sleep Problems

Sleep issues are one of the most common signs of childhood anxiety. Three out of four anxious children have sleep difficulties, though they look different by age. Younger kids (ages 6 to 11) wake up more at night and worry about sleep itself, while teens experience more daytime sleepiness.

“Teens staying up later may be avoiding sleep and staying busy because being alone with their thoughts feels overwhelming,” Chansky says.

3. Angry Outbursts or Tantrums

Mood swings are normal, but frequent anger might signal underlying anxiety. “A lot of times anger is the protector for vulnerable feelings,” Chansky says. A child anxious about playground social dynamics might not express worry, she says. Instead, they become explosive and short-tempered because they feel helpless about their situation.

4. Avoidance

When anxiety takes over, kids start saying no to things they used to enjoy or should be doing. Rather than saying to you directly, “I don’t want to try out for the play because I’m afraid I’ll make a fool of myself,” they’ll outright avoid it. This might look like suddenly not wanting to go to school, skipping time with friends, avoiding sports tryouts, or refusing to participate once they’re on a team.

5. Physical Complaints

Anxiety lives in the body. Children might complain of stomachaches before school, headaches during tests, or general fatigue. “When anxiety activates our fight-or-flight system, we can get muscle tension and fast breathing,” says Regine Galanti, PhD, licensed clinical psychologist and author of Parenting Anxious Kids. These physical symptoms are often the first sign parents notice.

6. School Struggles

Anxiety often impacts academic performance. Research shows anxious kids miss more school, participate less in class, and their grades may suffer. Before assuming your child is being defiant about homework or lazy about studying, consider whether anxiety might be driving those behaviors.

What Causes Anxiety in Children?

Childhood anxiety results from a complex mix of genetic, environmental, and developmental factors—and it’s not caused by “bad” parenting.

Even loving, stable families can have children with anxiety. Understanding the risk factors can help you recognize patterns and stop blaming yourself for something that often has biological roots.

Common risk factors include:

Genetics and biology: Family history of anxiety or mood disorders, plus individual temperament traits like sensitivity, shyness, or intense reactions to change.

Environmental stressors: Negative life events, academic pressure, bullying or peer problems, major family changes, or exposure to trauma.

Parenting patterns: Overprotective parenting (though well-intentioned), inconsistent boundaries, or family stress—but remember, anxious children often make parents more protective, not the other way around.

The reality: anxiety usually develops from multiple factors working together, not one single cause. A sensitive child might handle stress fine until they hit a perfect storm of middle school social pressure plus a family move. It’s rarely anyone’s fault.

What to Say to a Child With Anxiety

The key to talking with an anxious child is to validate their feelings while helping them evaluate whether their worries are helpful or accurate.

No matter your child’s age, it can feel overwhelming to find the right words. But these conversations are the foundation of helping your child manage anxiety.

“It’s so important for parents to take this seriously and know how to communicate with their kids about worries so they can get good at helping them manage their fears and anxieties,” Chansky says.

Here’s a five-step approach:

Step 1: Identify the Specific Worry

Anxiety rarely says “I’m anxious.” Instead, it shows up as vague dread or “what if” thinking. Help your child get specific about what’s actually worrying them.

For example, if they’re worried about riding the bus tomorrow, dig deeper: Is it because it’s loud? They might not have anyone to sit with? They’re worried about throwing up? Getting to the root helps you address the real concern rather than the general fear.

Step 2: Validate Their Emotions

Let them know that uncomfortable emotions are part of life—and they don’t mean you should avoid the situation. “We want to get the message across that it’s OK that you feel like this and you can still do this task/go to school/be on a team. I will help you,” Galanti says.

The key word is “and,” not “but.” You’re not dismissing their feelings; you’re showing them they can feel scared and still do hard things.

Step 3: Evaluate the Worry Together

“We want to teach kids how to test their worries instead of trust them,” Chansky says. Try this script:

“If you’re worried about something, it makes sense that an alarm has gone off for you. However, that’s your worry voice. Let’s fact-check it. Is it telling you anything that’s helpful?”

For younger children, you can make this concrete with puppets or stuffed animals—one character plays the worry voice. “We’re helping to create that awareness that the thoughts we have are trying to help us, but they’re not necessarily reliable,” Chansky says.

Ask questions like: What do you think is really going to happen? Is this more of a fear than a fact?

Step 4: Set Boundaries Around Worry Time

Worries can become endless loops. Galanti recommends setting limits on how long you’ll discuss a topic. If your high schooler is anxious about a test but you’ve already talked through her study plan, next time she brings it up, agree to revisit it for two minutes, then move on.

This isn’t dismissive—it’s teaching your child that worry time has limits and life continues beyond the anxiety.

Step 5: Help Them Calm Their Body

After talking through the worry, help your child address any physical symptoms they’re experiencing. Young children especially benefit from physical coping strategies since they may not yet have the words to fully express their anxiety.

Simple body-calming techniques include:

• Taking a walk together outside
• Deep breathing exercises (try “smell the flower, blow out the candle”)
• Progressive muscle relaxation or gentle stretching
• Mindfulness videos designed for kids
• Listening to calming music while doing a quiet activity

Remember: anxiety lives in the body, not just the mind. Sometimes physical strategies work when talking alone doesn’t.

How to Help a Child With Anxiety at Home: 5 Expert Tips

Creating a supportive home environment involves balancing structure and gradual exposure to fears while building your child’s confidence through small, manageable challenges.

After talking through their worries, it’s time to take action—together. These strategies help anxious children feel secure while slowly building their ability to handle difficult situations.

1. Maintain Predictable Routines

Keeping a stable, regular routine at home gives kids a sense of security when the outside world feels chaotic. “When there’s no visible structure for kids to rely on, it starts to feel scary,” Chansky says. This doesn’t mean rigid schedules, but consistent bedtimes, family meals, and predictable daily rhythms that help anxious children know what to expect.

2. Monitor and Filter Media Exposure

Kids today absorb world anxieties through social media, news snippets, and overheard conversations—not just the evening news. Keep your home environment age-appropriate and talk through any upsetting information they encounter. If your child hears about a school shooting or natural disaster, don’t ignore it. Acknowledge their concerns and provide reassurance appropriate to their developmental level.

3. Prioritize One-on-One Connection Time

Regular individual time with your child builds the foundation for everything else. “Once you have a foundation in place, it’s much easier to do the things you need to do with a child with anxiety, which is to back away and help them face their fear,” Galanti says. This might be 15 minutes of undivided attention daily—no phones, no siblings, just focused connection.

4. Help Them Face Fears Gradually

Exposure works—when you encounter something repeatedly, your brain learns to turn off the fear response. But this process is messy. “There’s no way for a child to stop being scared just because a parent wants them to,” Galanti says.

The goal isn’t avoiding scary situations; it’s taking small steps toward them. If your child fears dogs, still take that neighborhood walk even knowing you’ll see dogs. When your child cries seeing a dog across the street, praise them for being brave enough to be there. Progress, not perfection.

5. Build Independence Through Small Challenges

Give your child age-appropriate opportunities to do things on their own. Have them order their own food at restaurants, check out library books, pay the cashier at stores, or ride their bike around the block. These small victories build confidence and show them they can handle more than they think.

When to Seek Professional Help

Consider professional support if your child’s anxiety symptoms persist for more than a few weeks and significantly interfere with daily activities, school performance, or social relationships.

Kids naturally have ups and downs, but some signs indicate it’s time for additional support:

• Persistent symptoms that last weeks, not days
• Significant interference with school, friendships, or family life
• Physical symptoms that don’t have medical causes
• Avoidance that’s getting worse, not better
• Your family feels stuck despite trying strategies at home

Both your child and you can benefit from professional help. Your child might work with a therapist, but parent coaching can be equally valuable. “Kids can benefit from parents getting coaching on how to talk about and help manage anxiety in their children,” Chansky says. Recent research shows this parent-focused approach effectively reduces children’s anxiety.

Remember: seeking help is a sign of strength, not failure. “Parents might come into this overwhelmed, and that’s OK. But there are a lot of reasons to feel encouraged,” Chansky says. “Anxiety is a treatable condition, and giving kids the tools they need goes a long way to help them manage life well and thrive.”

You’re already taking the most important step by recognizing your child’s struggles and seeking information. Professional support can help you both build on that foundation.