Anxiety is a natural part of childhood, often experienced during transitions like starting school, taking exams, or facing unfamiliar situations. However, a child may have an anxiety disorder if their worry becomes overwhelming, chronic, or interferes with their day-to-day functioning. According to the Anxiety and Depression Association of America (ADAA), anxiety disorders are the most common mental health issues in children and adolescents, affecting approximately 1 in 8 children (ADAA, 2020).
Understanding the common symptoms of anxiety in children is crucial for early identification and support. Since children may lack the vocabulary to express their worries, anxiety often manifests through physical complaints, behavior changes, or emotional outbursts.
What Is Childhood Anxiety?
Childhood anxiety involves intense fear or worry that is disproportionate to the situation and often difficult for the child to control. While occasional fears are developmentally appropriateâsuch as fear of separation in toddlers or fear of the dark in early childhoodâclinical anxiety tends to be more chronic, intense, and impairing.
Types of anxiety disorders in children include:
- Separation Anxiety Disorder
- Specific Phobias
- Panic Disorder
- Obsessive-Compulsive Disorder (OCD) (often overlaps with anxiety symptoms)
Common Symptoms of Anxiety in Children
- Excessive Worry
Children with anxiety often worry persistently about a wide range of topics, school performance, health, family safety, or natural disasters. These worries are usually irrational and difficult to soothe.
E.g. A child may repeatedly ask if their parents will be okay when they leave for work, despite no evidence of danger.
2. Physical Complaints
Anxiety frequently presents with somatic symptoms, especially in younger children who canât express emotions verbally. Common physical signs include:
- Headaches
- Stomach aches
- Nausea or vomiting
- Dizziness
- Rapid heartbeat
- Fatigue
Note: These symptoms often worsen during anxiety-provoking situations (e.g., before school or public speaking) and subside when the perceived threat passes.
3. Avoidance Behaviors
Children with anxiety tend to avoid situations that trigger their fear. This avoidance may seem like stubbornness or resistance, but is often a coping mechanism.
For e.g:
- Refusing to attend school (school refusal)
- Avoiding social gatherings
- Clinging to parents in unfamiliar settings
Clinical Insight: According to the American Academy of Child and Adolescent Psychiatry (AACAP), persistent avoidance is a red flag for an anxiety disorder (AACAP, 2021).
4. Sleep Difficulties
It might be challenging to get to sleep and stay asleep when you’re anxious. Children may complain of nightmares, fear of the dark, or needing a parent to stay with them.
Signs include:
- Trouble falling asleep due to racing thoughts
- Frequent night awakenings
- Reluctance to sleep alone
5. Irritability and Outbursts
Anxious children often appear moody, irritable, or easily frustrated. Their emotional bandwidth is overwhelmed, leading to meltdowns over seemingly small issues.
Tip: These emotional reactions are not defiance, but a signal of internal distress.
6. Perfectionism and Fear of Failure
Children with Generalized Anxiety Disorder often show unrealistic standards for themselves, fear of making mistakes, or distress when things donât go as planned.
Behaviors may include:
- Repeated erasing or restarting schoolwork
- Excessive checking or reassurance-seeking
- Crying or tantrums when outcomes arenât perfect
7. Need for Reassurance
Constant reassurance-seeking is a hallmark of childhood anxiety. The child may ask the same questions repeatedly, even after receiving a response.
Common phrases include:
- âAre you sure?â
- âWhat if something bad happens?â
- âCan you promise me it will be okay?â
8. Social Withdrawal or Shyness
Despite the fact that some children are naturally timid, social anxiety results in a profound fear of being scrutinized or humiliated. Children may avoid speaking in class, performing, or meeting new peers.
Red flags:
- Refusing to speak in school (selective mutism)
- Crying or freezing in social settings
- Avoiding eye contact or group activities
9. Obsessive Thoughts or Compulsive Behaviors
In some cases, anxiety manifests as repetitive thoughts (obsessions) or actions (compulsions), particularly in Obsessive-Compulsive Disorder (OCD).
E.g.,
- Fear of germs leading to excessive hand washing
- Demanding that everything be “just right” in order to prevent bad outcomes
When to Seek Help
It’s critical to differentiate between clinical anxiety and typical developmental worries. Seek professional support if:
Symptoms persist for more than 4 weeks
Anxiety interferes with school, friendships, or family life
The child is distressed and unable to manage their fears
Early intervention through counseling, cognitive-behavioral therapy (CBT), and family counseling can significantly improve outcomes (Comer et al., 2011).
Supporting an Anxious Child
- Validate their feelings without judgment
- Teach coping strategies like deep breathing or journaling
- Encourage gradual exposure to feared situations
- Model calm behavior and emotional regulation
Conclusion
Anxiety in children can be subtle or dramatic, but it is always a real emotional experience for the child. Being aware of the common symptoms enables parents, educators, and mental health professionals to provide timely support. Apprehensive children can learn to manage their environment with resilience and confidence if they are given the proper resources, empathy, and understanding.
Consult Dr. R.K. Suri, a leading clinical psychologist and life coach, and Ms.Chanchal Agarwal, a renowned counseling psychologist.
References
- Anxiety and Depression Association of America (ADAA). (2020). Understanding Anxiety in Children. [https://adaa.org]
- American Academy of Child and Adolescent Psychiatry (AACAP). (2021). Anxiety Disorders Resource Center. [https://www.aacap.org]
- Comer, J. S., Kendall, P. C., Franklin, M. E., Hudson, J. L., & Pimentel, S. S. (2011). Obstacles to the dissemination of evidence-based treatments for youth anxiety and depression. Clinical Psychology: Science and Practice, 18(1), 36â54.
- Bernstein, G. A., & Layne, A. E. (2006). School refusal and anxiety disorders: A review of the literature. Child Psychiatry and Human Development, 37(1), 25â46.