How to Spot Anxiety Symptoms in Children

Anxiety symptoms in children can easily be misunderstood.

Parents might see a child who is irritable, clingy, avoiding obligations, or angry and call it oppositional or manipulative.

However, these behaviors don’t always reflect what is going on inside the child. In fact, when viewed through this lens, it would be very easy to miss the child’s signals of distress.

Understanding anxiety symptoms in children, therefore, begins with learning this distinction. When parents change their perception of their child’s behavior, they can recognize the signs and respond with more patience and compassion rather than anger and criticism.

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What Is Anxiety?

Imagine your child is afraid to go to sleep at night, convinced a boogeyman is under the bed. You might reassure them that there is no danger, check under the bed, tuck them in, and walk away.

For many children, this simple reassurance might be enough to help them relax and fall asleep. However, not all children respond in this way. For others, this fear grows until rational thought disappears, despite your reasonable and kindhearted efforts.

Anxiety is the body’s response to a perceived danger (National Institute of Mental Health, 2023). If this fear subsides and passes, it is considered a worry or concern.

Brief moments of anxiety can be helpful when they highlight potential threats and allow us to protect ourselves. However, when worry and fear become persistent and impossible to release, anxiety paralyzes instead of protects.

A “normal” or “typical” worry or fear is generally a single event that takes place in your brain. Anxiety, on the other hand, is a persistent and felt distress response that includes body sensations, emotions, and thoughts (American Psychiatric Association, 2022).

Children, with their developing regulatory system, have stronger and more physical reactions that are often difficult to put into words. As a result, their behavior expresses what they cannot give voice to.

Anxiety becomes problematic when the protective role goes into overdrive and begins to interfere with daily functioning. Imagine, for example, that the volume button is stuck on high and can’t be turned down. This is the experience children with anxiety have.

For a child, a routine expectation of going to school, meeting new people, or eating certain foods can feel like a terrifying total body experience that cannot be turned down or off.

With an understanding of what anxiety feels like inside a child’s mind and body, it becomes easier to see how that same distress shows up in their behavior and emotions.

How Do Anxiety Symptoms in Children Show Up?

Anxiety usually shows up in three ways: physically, emotionally, and behaviorally (Centers for Disease Control and Prevention, 2024).

Common physical sensations include difficulty sleeping, stomachaches, headaches, rapid heartbeat, sweating, and muscle tension.

Emotional reactions such as persistent irritability, tearfulness, excessive worry, meltdowns, or sensitivity to criticism might also indicate a child is struggling with anxiety.

Behavioral cues such as avoiding new activities, school, or social settings; being overly clingy; frequently needing reassurance; and trying to over-control routines are all common signs.

However, anxiety is not a one-size-fits-all experience and often looks very different from one child to the next. For some, anxiety symptoms appear as restlessness and fidgeting. For others, it looks like withdrawal or completely shutting down.

Even more confusing is that the child’s behavior may express something entirely different than what is happening inside.

For example, a child who refuses to go to school or a social event might appear manipulative or defiant. However, when considered further, their refusal could be fear of separation, noise, or standing out.

Likewise, a child who spends hours working and reworking homework may not be driven by ambition, but fear of making a mistake. In both cases, the external behavior masks the internal experience.

Because children’s communication skills are not fully developed, they often show anxiety symptoms through their actions (Child Mind Institute, n.d.).

Their reactions and behaviors aren’t conscious or deliberate choices. They are automatic responses from the child’s nervous system when they perceive a threat.

Once activated, they send distress signals to the body, such as a racing heart, headache, or tears. As a result, the child’s behavior expresses what they cannot easily control or put into words.

Why Does Anxiety Show Up?

Anxiety doesn’t come from only one source. It can come from a combination of biological, environmental, and learned responses (Beesdo et al., 2009).

This helps explain why children in the same environment can have completely different emotional experiences and reactions. While there is no one single reason why anxiety symptoms show up in children, there are several possible contributing factors.

Environmental change and loss of safety

Anxiety can develop when a child’s safety or predictability is taken from them. Imagine an outgoing child who easily makes friends and engages in activities. Now imagine what happens after a divorce and relocation from a large house with a yard to a small apartment in a new city.

The child has lost familiar surroundings, friends, school, and routines, yet the expectation to adjust and engage remains. It’s easy to see how the child becomes quiet, fearful, or withdrawn as the known world collapses into unfamiliarity and uncertainty.

Biology and temperament

Some children feel their emotions more intensely than others. Factors such as genetics, brain chemistry, and temperament play important roles in how a child’s nervous system reacts to stress (Beesdo et al., 2009).

Take, for example, a child who is naturally cautious or sensitive. This child isn’t intentionally choosing to worry or be afraid. Instead, their internal wiring naturally reacts more strongly than others.

Learning and modeling

Parents’ own reaction to stress has a profound impact on how children learn to process theirs. Imagine that every time the doorbell rings the parent reacts with panic, worrying out loud whether a stranger is coming to harm them.

It is only natural that a child would internalize this reaction as normal. Conversely, when adults model calm and thoughtful responses to new or difficult situations, they set a tone as well. Children learn that emotions can be managed calmly and safely, even when they are stressful.

The need for safety and control

Anxiety often arises when children feel they cannot control or maintain their pattern or routine. When their schedule changes suddenly, and they haven’t been told or had time to adjust, it can be very unsettling. If they react strongly or refuse to adjust their schedule, it’s easy to characterize their behavior as stubborn or inflexible. However, their need to maintain predictability by avoiding uncertainty allows them to feel safe.

Anxiety is not a disability or flaw. It is a signal of an unmet need for safety, stability, or reassurance (National Health Service, 2024). When they can see their children’s behavior through this lens, parents are better equipped to respond from a space of patience and compassion rather than anger or criticism.

A Take-Home Message

Anxiety in children is their body’s way of saying, “I don’t feel safe.”

When parents understand the anxiety symptoms in children, how they show up, and why they happen, they can change their perception of their child’s behavior and recognize these signs of distress.

Such awareness can help soften frustration into understanding and empathy with stronger connection and support.

Slowing down to understand the signal behind the behavior is the first step toward helping an anxious child feel safe.

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