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In focus: Understanding anxiety in children

Definition

Emerging Minds acknowledges that families come in many forms. For the purposes of easy reading, the term ‘parent’ encompasses the biological, adoptive, foster and kinship carers of a child, as well as individuals who have chosen to take up primary or shared responsibility in raising that child.

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A child’s life is full of big moments and new experiences, like the first time they ride a bike or their first day at high school. Feeling nervous or anxious is normal as children grow up, learn about the world and experience new things.

This resource aims to help parents understand when their children or young people might need some extra support to manage their fears and worries, and the role you can play in reducing the risk, or impact, of anxiety for them.

What is anxiety?

Anxiety is a common reaction to stressful or new situations. It’s our body’s way of letting us know when to be on guard as part of our ‘fight or flight’ response. Depending on the situation you’re facing, anxiety can feel like slight nervousness through to a racing heart and excessive sweating. Most of the time these feelings come and go, and don’t last long. But these feelings can become a problem if they persist and prevent us from doing things that are important to us.

Just like adults, children feel anxious sometimes. But if anxious feelings last a long time, cause distress and/or prevent your child from doing activities that are important and meaningful to them (like going to school or seeing friends), they may need support to learn how to manage these feelings. By identifying and addressing issues early, you can help to reduce the risk of your child experiencing anxiety into adolescence and adulthood.

Anxiety is a common reaction to stressful or new situations. But if anxious feelings last a long time and prevent your child from doing things like going to school or seeing friends, it is important to think about strategies that can help or to access a professional that can provide support.

Recognising anxiety

Anxiety is the most common mental health difficulty in children and adolescents. But it can be easy to miss.

Anxiety may show up as physical symptoms, such as a fast heart rate and tears when leaving a parent for the first time or butterflies in the stomach and feeling nauseous before going to a new friend’s birthday party. Children may have trouble concentrating, be more tired than usual and might seem irritable.

Anxiety generally looks different and is related to different developmental milestones in each age group:

  • Infants (aged 0–12 months) – Anxiety in infants usually relates to separation from their main caregiver (the parent or carer they’ve spent the most of their time with). It is very normal for infants to experience fear of being away from their caregivers. This can begin as early as four or five months of age but is more common from around nine months. They may be irritable, difficult to settle, or have problems with sleeping or feeding.
  • Toddlers and preschoolers aged 2–4 years tend to experience anxiety around changes in their routine and being away from parents and/or with unfamiliar people, for example, at childcare or preschool. Anxiety may also arise in response to new independence related to activities such as toileting, eating and sleeping. Read more about anxiety in toddlers and preschoolers.
  • Primary schoolers aged 5–11 years mainly experience anxiety as worrying thoughts, when they start experiencing more of the world around them. Anxiety may be expressed in physical symptoms, such as tummy aches and trouble sleeping. In the early school years children may refuse to go to school and feel anxious about the dark, monsters or ghosts. Read more about anxiety in primary school-aged children.
  • Young people aged 12+ years (teenagers) usually experience anxiety about themselves (thoughts and feelings about how they look), how they relate to other people (friendships and relationships) and what other people think of them. They also worry about the potential impact of ‘world events’ like bushfires, floods or war, as they learn more about these via the news and social media. They may avoid situations or things they feel anxious about – for example, saying they’re too sick to go to school or to a party, or spending a lot of time on social media or video gaming rather than doing a school assignment. Read more about anxiety in young people.

Types of anxiety

There are many different types of anxiety but the following are the most common in children and young people:

  • Generalised anxiety causes children to worry about a lot of everyday things, which differ depending on the child’s age. While toddlers and preschoolers may be scared about monsters under their bed, older children may be worried by what they have heard or seen about natural disasters on TV or social media, or about something they have done and the potential (often unrealistic) consequences.
  • Social anxiety revolves around friends and social settings. Younger children may appear shy and uncertain about meeting new people and/or forming friendships, while older children might worry about how they will be judged or talked about, or if people like them.
  • Separation anxiety relates to a child’s fear or distress at being away from their main caregiver/s (more than kids their age usually feel). Younger children may have trouble understanding why they must be away from their parent. Older children may worry about being permanently separated from their parents or family due to something bad happening, such as a plane crash.
  • Anxiety related to trauma may occur when a child is exposed to a traumatic event such as a car accident, bushfire or domestic violence. Younger children may relive the event in their drawings or games they play. Children of all ages may be more irritable and have problems sleeping.

If you are interested in learning more, Beyond Blue has more detailed information on the different types of anxiety.

‘Mental health is a very important factor in everyone’s lives, whether it’s anxiety, depression or stress, etc. Everyone will experience some sort of normal negative mental health in their lifetime. However, this should not be something you suffer with everyday.’

Female, 14 years, North Queensland

Signs of anxiety

When we experience anxiety our body, feelings, actions and thoughts can be affected.

Children experience and describe anxiety in lots of different ways. When feeling anxious, children may have:

  • increased irritability and outbursts
  • butterflies or a ‘sore tummy’ (stomach pains)
  • headaches and dizziness
  • an increased awareness of their heart beating/beating really fast
  • trouble concentrating at school – because they’re distracted by worrying thoughts; and/or
  • trouble sleeping.

Children can respond to anxiety in different ways. Some children may display externalising behaviours, or behaviours that is easy to observe. Some of these observations may at first be interpreted as ‘naughty’ or ‘defiant’ behaviours but may in fact be the child’s way of avoiding a situation that makes them feel anxious.

Other children may internalise their experience, where it appears they are coping but are in fact holding onto a lot of worry and concern on the inside. This might come out in smaller behaviours or patterns that a parent may notice, particularly in older children or teenagers.

Children and young people might avoid or try to get away from certain situations, people or objects that bring on anxious feelings. For example, they might say they’re sick to stay home from school or want to leave a party early. Some children may feel self-conscious or become extremely ‘clingy’ around you. They might cry and/or be unwilling to leave you when faced with a new activity or task.

Children feeling anxious often seek reassurance – sometimes repeatedly – from parents or other adults. They might ask a lot of questions, like ‘What’s going to happen?’, or ‘What are we going to do if…happens?’, or ‘Will you stay with me?’

Try to always be curious about your child’s emotions and what might be behind their behaviours. To develop a better understanding of your child’s experience of anxiety, read more about it in Supporting a child with anxiety.

For more examples of thoughts, feelings and physical sensations that are common signs of anxiety in children, refer to our age-specific resources.

Anxiety in toddlers and preschoolers Anxiety in primary school-aged children Anxiety in young people

When a child’s anxious thoughts and feelings have an ongoing impact on their ability to enjoy and/or participate in one or more aspects of their daily lives it is important to seek further support. Speaking to your general practitioner (GP) is a great place to start as they can offer strategies to help or provide other resources should they be required.

Learn more about the role of a GP in this video.

What causes anxiety in children?

A child’s mental health and wellbeing are shaped by various factors including genetics, their family and social environments, and temperament (learn more about this in Emerging Minds’ resource, Understanding temperament and anxiety: A guide for parents).

Anxiety is generally caused by a combination of factors, including more than one of the following:

  • Genetics/family history. Anxiety can be passed down through families, particularly if there has been a history of significant stress and trauma. Additionally, some children are born with a more anxious temperament than others.
  • Past experiences. For example, if a child has been bitten by a dog, they may become anxious around dogs.
  • Learning from others. Children can develop worries or fears because of the reactions or comments of their parents, siblings or other people around them. For example, if a parent is obviously anxious when a dog approaches or says something like, ‘Be careful of the dog, it might bite you; stay near me!’, their child may develop anxiety around dogs.
  • Traumatic or stressful events. Experiencing a traumatic event like the death of a loved one, or a bushfire, can have major impacts on a child’s mental health. Children who experience lots of family/household stresses or adverse childhood experiences (ACEs) – like low household income, having an ill parent or family violence – are at higher risk of anxiety.
  • Media exposure/social media use. Children also are influenced by what they see and hear on TV and other media. Greater exposure to news and social media means children may be getting constant reminders of ‘threats’ like COVID-19, bushfires and floods, and war. They also may feel pressure to be ‘perfect’ or develop worries about their appearance because of unrealistic images on social media.

If you have anxiety, or have experienced anxiety in the past, it’s important to understand how your experience and reactions can affect your children and how you can reduce their risk of developing difficulties with anxiety.

Supporting a child with anxiety

The good news is that there are simple, practical strategies that parents and children can use to prevent and reduce the impact of anxiety on daily life. The goal is to help your child develop skills to manage anxiety so it doesn’t get in the way of them doing the things they enjoy and living their best life.

No parent wants to see their child unhappy or fearful and it’s natural to want to protect your child. But enabling or allowing them to avoid the situation, object or person that causes them anxiety ultimately does more harm than good; and forcing them to confront those things doesn’t help either. The challenge for many parents is finding the balance between these two approaches.

You can help your child gradually face their worries or fears and build up their confidence and coping strategies so that, over time, their anxiety will decrease.

By creating a safe space which allows your child to talk about their feelings you will be well placed to know how to support them or seek professional help if required. Remember to stay curious and validate their experiences in the way you respond and your body language. Nodding your head to show understanding and giving them the space to speak is important; and asking open ended questions such as ‘How do you feel in your body when X happens?’, will help make them feel like you are really listening.

Children who are supported to cope with worry or anxiety and develop resilience when they are young are less likely to have anxiety problems as teenagers or adults because they have learned valuable skills that will help them through future difficulties.

Learn more about supporting your child and practical strategies they can try at home.

Getting professional support

Feeling anxious, stressed, angry or scared are all common for children as they are growing up and learning about the world. It can be hard to tell if what your child is experiencing is usual childhood anxiety, or if they might need further professional support to manage their anxious thoughts and feelings.

You’re the expert on your child. If you feel their anxious thoughts, feelings or behaviour are impacting on their daily life, wellbeing, learning, or relationships with friends and family then talk to your GP. They can provide support and recommend further resources if required.

Anxiety in children is treatable and getting help early can prevent it becoming a bigger problem when they are a teenager or adult, while providing them with opportunities to build valuable resilience skills.

‘When Mum suggested we go and speak to someone about how I felt I didn’t really understand how talking about it would help. My psychologist was lovely. She really helped me and it’s made such a big difference.’

Abby, 18 years, South Australia

The more you understand about your child’s experience of anxiety, the better able you will be to help them and make decisions about if and when professional support is needed. By having patience and remaining curious about your child’s feelings and thoughts, you can help your child to manage anxiety and experience all that life has to offer.

Anxiety in toddlers and preschoolers Parenting with anxiety Can’t find what you’re looking for?

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