What is anxiety in children?

Worry and anxiety is a normal part of life that helps people stay alert, motivated and focused.

Many children have anxious feelings or fears that can come and go.

Having anxieties about certain things can also help your child behave safely. For example, a child with a fear of fire may avoid playing with matches.

Some children find the world to be more scary than others. They might find it hard to understand and manage their fears, which can affect their life.

If you are concerned about your child’s anxiety, you should seek professional help.

What are the symptoms of anxiety in children?

When your child is frightened or anxious, they may:

• want to avoid certain places or situations
• want to escape a situation quickly
• become clingy, impulsive or distracted
• need regular reassurance
• panic or have a tantrum
• have a fast heartbeat
• feel sick or have ’butterflies’ in their stomach

Is my child’s anxiety normal?

‘Normal’ anxiety in your child might include feeling afraid or worried about doing something new, like starting a new swimming or dance class. They may also have anxious feelings for things such as strangers or animals.

Children may learn to fear something after having an unpleasant experience with it. For example, they might fear dogs after being bitten by one.

Some childhood fears only appear in certain situations. For example, your child might be afraid of a friend’s dog, but not a lion at a zoo.

If your child is struggling with fears and anxieties, there are things to look out for. They may:

• have lots of tantrums, sometimes for no clear reason
• have nightmares or trouble sleeping
• show aggressive behaviour or struggle to get along with other children
• regularly avoid certain people, situations or places
• avoid family, friends or school
• struggle to concentrate
• have a change in appetite
• have headaches and stomach aches

A child can also develop physical symptoms because of their anxiety such as panic attacks. Panic attacks cause symptoms like:

• a fast heartbeat
• a tight chest or chest pain
• light-headedness
• hot and cold flushes
• a feeling of terror or dread

Your child may need extra support for an anxiety disorder if:

• they seem to be constantly anxious and distressed
• their fears interfere with their daily life
• they do not outgrow age-appropriate fears

What are normal anxieties and fears for my child’s age?

Your child’s anxieties and fears will change as they get older.

One fear may disappear or replace another. For example, your child who was once afraid of the dark may now enjoy scary stories at sleepovers.

There are some fears that are expected as your child grows up.

Babies

Babies may have stranger anxiety. They may cling to you when meeting someone they don’t recognise. They may also fear loud noises like the vacuum cleaner.

Toddlers

Toddlers may experience separation anxiety. If you leave, they might be distressed or throw a tantrum. This is because they do not yet understand why you’ve left, when you will come back or if you will come back.

Preschool

At around preschool age, your child will develop more of an imagination. They might be afraid of imaginary things and the dark.

School-age children

As your child gets older, they might develop fears about real-life things that could happen such as natural disasters, injury, illness or death.

They might still have some fears of imaginary things such as monsters and ghosts.

School-age children may also develop generalised anxiety, where they worry about a lot of things. This often happens when they start school.

What are the different types of childhood anxiety?

There are some types of anxiety that are most common in children. Children with anxiety disorders often need extra support.

Generalised anxiety disorder

Generalised anxiety is when a child worries about many things in everyday life such as:

• how good they are at school
• things they have done in the past
• speaking up or asking questions in class
• their popularity or if people like them
• tests and assignments

If your child has generalised anxiety disorder, their worries may be intense, unrealistic and overwhelming. They may find it difficult to concentrate.

Separation anxiety

When children have separation anxiety, they become distressed when they are away from you. This is common and normal in young children, especially when starting day-care.

If your child has separation anxiety and is older than 2 years, they may have separation anxiety disorder. Children with separation anxiety disorder may fear that something will happen to you while you’re away. Or they may think you will not come back. This can also make it difficult for them to go to school.

Social anxiety

Social anxiety disorder is like a severe kind of shyness. It is linked to a worry they will do or say something wrong or be criticised. If your child has a social anxiety disorder, they may feel very worried about talking to new people or participating in school.

They may have low self-confidence and find it hard to make friends.

Obsessive compulsive disorder

Obsessive compulsive disorder (OCD) can cause your child to have persistent unwanted thoughts. For example, they may think constantly about dirt and germs. This can lead them to wash their hands more often than expected.

Phobias

Some children develop phobias.

A phobia is a strong, irrational fear of a particular situation or thing. Your child’s phobia may cause them to feel panic that’s more intense than the thing they are afraid of. They will try to avoid the thing that causes their phobia.

In children, phobias are often about:

• dogs
• spiders
• the dark
• storms
• clowns
• heights
• injections

A phobia can be very difficult to tolerate, both for your child and those around them. It can be even more difficult if the cause of the phobia is hard to avoid such as social situations.

Post-traumatic stress disorder

Your child may develop post-traumatic stress disorder (PTSD) if they experience trauma. This could be after:

• violence or abuse
• something life threatening happening to them or those they love
• distressing things happening repeatedly

A child with PTSD may have flashbacks to traumatising events, which can be stressful and intrusive. They may also have trouble, sleeping, concentrating and managing their emotions.

Does my child need professional support?

Your child may need extra support if:

• they are more anxious than other children their age
• their anxiety lasts longer than 6 months
• their anxiety interferes with their daily life, such as with school, family or their friendships
• their fear seems more intense than the cause of their fear

If your child’s fear is normal for their age, it’s a good sign that it will resolve. While you shouldn’t ignore ‘normal’ anxious feelings, you can consider them part of your child’s normal development.

How is childhood anxiety treated?

If you are concerned about your child’s anxiety, contact your doctor or child health nurse. They can connect you with a mental health professional for children, such as a:

• counsellor
• psychologist
• paediatrician (children’s doctor)

Treatment for severe anxiety usually involves cognitive behavioural therapy (talking therapy) and counselling. This helps your child to:

• identify what they are feeling and why
• learn how to cope by thinking more realistically
• achieve their goals

Medicine can help with severe anxiety symptoms, but it is not usually recommended for children.

Find out more on Australian mental health services on healthdirect.

How can I help my child overcome their fears?

If your child has anxiety, there are ways you can support them.

You can start by trying not to be too overprotective. This can teach them that they need someone else to be able to do things. You also need to try and not be too dismissive of their worries as this will teach them that their worries are silly.

The best thing to do is help them develop skills to cope with their fears. This is important, to prevent their anxiety from becoming severe.

Supporting them will also help them gain confidence and build resilience.

Help your child learn about their fears

As silly as a fear may seem, it feels real to your child.

Listen to your child’s worries. Sometimes, just talking about your child’s fear with them can help them overcome it. Speak to your child about their fears using facts and logic.

Saying ‘Don’t be ridiculous! There are no monsters in your closet!’ may get your child to go to bed. But, it won’t make the fear go away, and they won’t feel supported by you. Instead, you can say ‘I checked in the wardrobe and there are no monsters in it’.

Your child may worry about things that are real, such as death or things they see on the news. Talk about it with them honestly to help them understand.

Help your child face their fears

Don’t avoid your child’s fears. For example, if your child fears dogs, don’t cross the road deliberately to avoid one. This will just reinforce that dogs should be feared and avoided.

If your child fears the dark, you can set up a night-light. This can help them learn that there is nothing in the dark that is going to hurt them.

Urge your child to have a go at experiencing new and scary things. Provide them with support and gentle encouragement, so that they are in control. You can act as a ‘home base’ for your child to return to after trying to approach their fear.

You can also help them break down their worries into smaller chunks. For example, if your child is scared of swimming, you can first:

1. take them to watch other children swim
2. encourage them to touch the water such as by dangling their feet in
3. help them feel comfortable in the shallow end, using floaties

You can also teach them some positive things to say to themselves when feeling anxious, such as ‘I can do this’ or ‘I can be brave’.

When your child tries something new or tries to face a fear, celebrate their effort with them.

Help your child understand their fear

You can help your child understand their fear by asking them to rate it.

Younger children can think about how ‘full of fear’ they are, with being full:

• ‘up to my knees’ as not so scared
• ‘up to my stomach’ as more frightened
• ‘up to my head’ as terrified

You can ask an older child to rate the intensity of the fear on a scale of 1 to 10, with 10 being the strongest.

If your child can rate fear, they may be able to see the fear as less intense than first imagined.

Teach children coping strategies

You can teach your child some techniques to manage their anxiety.

• Encourage them to take slow, deep breaths — tell them to imagine that their lungs are balloons, and let them slowly deflate (breathe out).
• Set aside a time to worry, rather than worrying all day.
• Tell them to imagine that they are floating on a cloud or lying on a beach, to help them relax.

Encourage them to think positively, rather than worrying about the worst-case scenario. You can also teach them how to plan for when things go wrong.

You can also model how to cope with anxiety through your own behaviour. When you get anxious, verbally say ‘I’m a bit scared of this, but I’m going to try it anyway’.

Resources and support

You can read more about helping your child on the Beyond Blue website. You can also chat with a counsellor online or by phone — 1300 22 4636.

The Brave Program is an interactive, online program for the prevention and treatment of childhood anxiety.

Kids Helpline offers counselling for children and parents over email, the web, or by phone — 1800 55 1800.

If you or a young person you are caring for needs support, you can visit the ReachOut website.