Anxiety in Children: Symptoms to Look For

Medically Reviewed by Renee A. Alli, MD on July 21, 2024
4 min read

Every child experiences times when they become worried or afraid. However, sometimes those feelings become overwhelming. That intense feeling is called anxiety.

Anxiety is a normal reaction to stresses in life. It is the body’s way of telling you about danger or caution in certain situations. However, sometimes that feeling lasts a long time and may affect sleep, energy level, or even interactions with friends and family.

Anxiety affects everyone differently. Both children and adults experience anxiety in their lives. When a child has anxiety, their worries can be so severe that they get in the way of school, home, or play. 

Understanding the signs of anxiety in children is an important step in helping them deal with their emotions and reactions to stress.

There is more than one kind of anxiety. Although most can be experienced at any age, they often present differently in young children. Some common anxiety disorders in children include: 

Generalized Anxiety Disorder (GAD)

Children with GAD worry excessively about a variety of things, such as family problems, relationships with their peers, or performance in school or sports. 

Panic Disorder

Children may experience dread or fear over small things, or for no reason at all. If a child suffers two or more panic or anxiety attacks (episodes where they are frightened or worried when no real danger is present) and spends the next month or more worrying over having another one or losing control, they may have a  panic disorder. 

Having a panic disorder means the person has a strong physical reaction to stress and does all they can to avoid reacting that way. That reaction normally involves visible upset — such as tears or hyperventilating (fast, deep breathing) — and chronic (long-lasting) worry.

Separation Anxiety Disorder

Between the ages of 18 months and three years, it’s very common for children to feel some anxiety when a parent leaves the room or their line of sight.

For children with separation anxiety disorder, this may occur at an older age. It may take them longer than most children to calm down. Affecting 4% of children, this disorder includes extreme homesickness and feelings of misery over not being near loved ones. 

Specific Phobias

If a child has a specific phobia, they have an intense and irrational fear of a certain thing or situation. Common phobias in children include: 

  • Animals
  • Storms
  • Water
  • Heights
  • Blood
  • Darkness
  • Medical procedures 

Social Anxiety Disorder

Social anxiety disorder is also called social phobia. It’s characterized by an intense fear of social and performance situations. Without treatment, social anxiety can impair your child’s performance in school as well as their ability to socialize and make or maintain relationships. 

Because some children with anxiety can be quiet and eager to please, their symptoms may be overlooked. Parents and other authority figures should be alert to the numerous signs of anxiety so they can intervene as early as possible. 

Although many of the signs overlap, symptoms in children depend on what type of anxiety they’re presenting and what triggers seem to provoke them.

Signs and Symptoms of Separation Anxiety

  • Ongoing fears regarding the safety of parents and caretakers
  • Refusal to go to school
  • Frequent physical complaints, such as an upset stomach
  • Extreme worry about sleeping away from home
  • Clinginess/separation anxiety
  • Increased heart rate
  • Tantrums or panic when separated from parents
  • Sleep problems such as nightmares (or night terrors) 

Symptoms of Specific Phobias

  • Extreme fear regarding a specific thing or situation that lasts for six months or longer.
  • When exposed to a phobia, experiencing physical distress, including: 

Symptoms of Social Anxiety

  • Fears of meeting or talking to people
  • Avoidance of social situations
  • Few friends outside the family

Screening for Anxiety

The United States Preventive Service Task Force recommends screening for anxiety in children and adolescents ages 8 to 18 years and screening for major depressive disorder (MDD) in adolescents ages 12 to 18 years.

The earlier anxiety disorders in children can be treated, the better. Early treatment can prevent future difficulties, such as loss of friendships, failure to reach academic potential, and low self-esteem.

If any of the above symptoms get to a point where they are interfering with your child’s life, you should consider getting an evaluation from a qualified mental health professional, such as a child and adolescent psychiatrist, pediatrician, or licensed clinical social worker. The diagnosis is established through an in-depth history from the child and their parent/guardian, and use of age-appropriate screening questionnaires. 

If they determine your child needs treatment, they may suggest several options:

Therapy

They may also recommend cognitive behavioral therapy (CBT). This is a type of talk therapy, where a child tells a therapist about their feelings and experiences. CBT can help children with anxiety unlearn avoidance behaviors. It also helps them learn more helpful patterns of thinking. 

Another option is exposure therapy, which aims to systematically help a child face their fears. In this type of therapy, your child sees their fear or relives a moment that made them anxious (all while in a controlled environment, such as a therapist’s office). These sessions can be in person or virtual and may even involve play therapy in younger kiddos as well as parent involvement.

Over time and using techniques they learn in therapy, your child will be able to get more comfortable with their fears or worries and better work through similar moments in the future.

Antidepressants

Just as they would with an adult, a doctor may prescribe your child medication to help ease their anxiety symptoms. Antidepressants are typically the first choice.