Anxiety in Children

What is Normal?

by William Leever, PsyD

Feeling anxious is one of the body’s alarm systems – it alerts us to danger. For some people, their alarm system is more sensitive, and goes off even when there is little to no danger.

In many cases, anxiety is healthy and keeps us safe and motivated:

  • The anxiety I feel about passing a test at school motivates me to study.
  • The anxiety I experience when someone asks me to do something dangerous prevents me from going through with it.

Feelings of Anxiety to Expect During Development

Feeling anxious, nervous or afraid is common throughout child development and tends to occur in stages or phases.

  • During infancy, “stranger danger” is common among infants as they can differentiate faces of familiar and unfamiliar people.
  • As toddlers, close bonds with caregivers intensify and separating from them becomes difficult. This usually lasts from about ages 1 to 4 but can last longer for some children.
  • For school-aged children, they become more aware of real dangers in the world. Those include:
    • Storms
    • Fires
    • Accidents
    • Burglars
    • Illnesses, etc.

They focus on these dangers without understanding how often these issues actually occur.

  • Adolescents become increasingly focused on social acceptance, personal success and issues in society, and may experience anxiety about changes in these areas. Anxiety around experiences at school, such as grades, peers, and dating are common concerns for adolescents.

How Do We Know When Kids Are Feeling Anxious?

There are both mental and physical signs of anxiety, nerves, or fear. Some common signs in children include:

  • Expressing worry in the days, weeks or months ahead of a planned event.
  • Wish to avoid an activity.
  • Frequent "what if" questions about potential danger.
  • Need for constant reassurance from parent.
  • Physical symptoms (for example: tummy aches, headache, or nausea)
  • Irritability.
  • Difficulty sleeping.

Many times, anxiety is a temporary feeling that passes once a situation changes. Children can also learn ways to manage daily anxiety effectively over time.

Everyone feels nervous and worried sometimes. How can we help a child who is having anxious feelings? In general, the goal is not to eliminate anxious feelings altogether, but to help kids learn to move out into the world despite their worries.

Here are six suggestions for parents and caregivers to help kids manage feelings of anxiety:

  1. Validate their feelings, even if you don’t quite understand where it’s coming from. Your goal is to listen, seek to understand and normalize that feeling, even if it’s not something that you think they should be getting anxious about.
    • Try saying things like, “I understand what it’s like to be scared. Tell me about what’s making you nervous right now.”
    • Pay attention to not promise safety as this can also invalidate the feeling. For example, you can't promise your child will never be injured riding a bike, or they will never fail a test, or they will never be in an embarrassing social situation.


Instead try…

“Don’t be scared.”

(Dismisses feeling)

“I can tell you are worried about going to the doctor. I don’t like getting shots either. But I know you can be brave and we’ll get through it together.”

“You’ll be fine.”

(Promises of safety)

“I can tell you’re feeling nervous about trying to ride your bike, but I'm going to be there next to you to help you learn how to do it.”

“Are you worried about passing your test today?”

(Leads to anxiety)

“How are you feeling about today’s test?”


  1. Move Toward Anxiety. Avoiding the things that make us anxious or nervous makes anxiety stronger. Safely facing our fears makes anxiety weaker. The anxiety may not go away, but doing a task while being afraid is the most effective way of coping with anxiety. Some ideas to move toward anxiety include:
    • Helping your child break down a task they are nervous about into smaller steps.
    • Helping them practice things they are anxious about in a safe setting.
    • Challenging them to do one thing “afraid” this week.
    • Expressing confidence that you will be able to help your child through any challenge that comes along, and that they’ll feel less nervous the more they practice something new.
  1. Teach them to evaluate the evidence. Our fears and anxiety often come from the way we think about ourselves and the world. You can teach your children to come up with the evidence for and against their anxious thoughts. It can also be helpful to use examples of things your child has mastered in the past that they were initially worried about.
  2. Consider distraction. Find something to take your child’s mind off of what’s worrying them. For example, if you’ll have to wait some time for a doctor’s appointment that they’re nervous about, bring along an activity to keep their mind occupied, or bring up a game on your phone you both can play.

Relaxation exercises can be a great distraction for kids who are feeling nervous. Not only does it distract their scared thoughts, but it also helps relax the body. Try breathing or meditation exercises. Practice relaxation techniques with your child while they are calm, then they will be even more effective when they are practiced during these high stress times.

  1. Avoid adding to anxiety. Sometimes, well-intentioned adults ask questions or make statements such as “Are you worried about passing that test today?” This can make a child feel anxious about something they may have not been thinking about. Instead, try asking more neutral questions like, “Are you feeling ready for your test?”

Similarly, spending too much time trying to convince a child that “everything will be OK” can also make the feelings worse. Over placating gives too much attention to a situation and can send a message to the child that there is something to be worried about.

  1. Model healthy ways to manage anxiety. When adults provide good modeling of ways to manage anxiety, it shows kids they can do it too. Tell kids in your life about the times you feel nervous and how you are getting through it.

Anxiety Disorder Signs

Feelings of anxiety, fear and even short-lived panic are all normal emotions for children to go through, and usually don't influence their daily functioning. Anxiety as a feeling can become an anxiety disorder when it stops a person from doing things they want and need to do. Signs include:

  • Distress and constant worry that is out of proportion with the situation (such as crying, anger, hopelessness or sadness).
  • Consistent avoidance of typical activities or refusing to participate in social activities.
  • Physical symptoms (such as headaches, stomach pain or shaking/trembling), which interfere with normal activity.
  • Persistent sleep problems, nightmares or refusal to sleep alone.
  • Consoling or reasoning with a child is repeatedly needed for ordinary situations.

If you are noticing these patterns, it might signal the need to seek guidance from their pediatrician or a mental health professional.