What is anxiety in children?

All children have anxiety or fear about real and imaginary things. Children may feel afraid even if there is no immediate threat to their safety or wellbeing.

Temporary anxieties and fears are normal in children. They can come and go. But some children find it more difficult than others to manage their anxious feelings, and find the world scarier than others.

Fear triggers changes in children’s bodies and makes them want to escape quickly from situations. Their hearts beat quickly, they may begin to perspire and feel 'butterflies' in their stomachs.

A little bit of anxiety can actually help people stay alert and focused. Having fears or anxieties about certain things can also be helpful because it makes children behave in safer ways. For example, a child with a fear of fire would avoid playing with matches.

But if the anxiety is severe, it may disrupt their life. You should seek professional help from a doctor or child psychologist if you are concerned.

Is my child’s anxiety normal?

‘Normal’ anxiety might be feeling afraid or anxious when coping with a new situation. But signs your child may need extra support include:

• they are anxious more often than other children their age
• it’s interfering with friendships, school or family
• the fears or worries seem out of proportion to the issues in their life

Signs that your child is anxious about something may include:

• becoming clingy, impulsive or distracted
• needing reassurance
• panic or tantrums when separated from parents
• problems sleeping or nightmares
• faster heart rate and breathing
• nausea
• headaches
• stomach aches

Apart from these signs, parents can usually tell when their child is feeling excessively uneasy about something. Listening to their worries is always helpful, and sometimes just talking about the fear can help a child move beyond it.

What are the types of childhood anxiety at different ages

The nature of anxieties and fears changes as children grow and develop. They include fear of strangers, heights, darkness, animals, blood, insects and being left alone. Children often learn to fear a specific object or situation after having an unpleasant experience, such as a dog bite or an accident.

Separation anxiety is common when young children are starting daycare or school, whereas adolescents may experience anxiety related to social acceptance and academic achievement.

Here are examples of the kind of anxiety children may experience at different ages:

• Babies may experience stranger anxiety, clinging to parents when confronted by new people they don't recognise.
• Toddlers may experience separation anxiety, becoming distressed and even throwing tantrums when one or both parents or caregivers leave.
• Preschoolers may fear things like being in the dark.
• School-age children may have anxiety about things that aren't based in reality, such as fears of monsters and ghosts. They may also have fears that reflect real circumstances that may happen to them, such as bodily injury and natural disaster

As children grow, one fear may disappear or replace another. For example, a child who couldn't sleep with the light off at age 5 may enjoy a ghost story at a slumber party years later. And some fears may extend only to one particular kind of stimulus. In other words, a child may ask to pet a lion at the zoo but wouldn't dream of going near the neighbour's dog.

Some children develop phobias — a very strong fear of something specific, such as spiders or meeting new people – which can interfere with their everyday lives.

Others develop generalised anxiety, where they worry about a lot of things. This commonly happens when they start school and they may feel the need to be perfectionists, worry about tests, are afraid to ask questions in class and feel very stressed.

How is childhood anxiety treated?

If you are worried that your child has anxiety, the first step is to talk to your doctor or maternal child health nurse. They may suggest your child sees a psychologist or counsellor, or sometimes a paediatrician.

Sometimes children with severe anxiety may be treated in a specialist anxiety clinic or by the local mental health service. Treatment will usually involve talking therapy and counselling to help the child identify what they are feeling and why, teach them how to cope, and help them achieve their goals. Medication can help with severe anxiety symptoms, but it is not usually recommended for children.

The best thing you can do is not to help your child avoid the thing that scares them, but to teach them how to cope.

• Encourage them to stop and take some slow, deep breaths.
• Set aside a time to worry, rather than worrying all day.
• Break down their worries into smaller, manageable chunks.
• Encourage them to think positively, rather than worry about the worst-case scenario.
• Urge them to have a go.
• Show them how you overcome scary situations.
• Help them to feel they have some control.
• Talk through their fears.
• Try not to be too over-protective, and help them work things out for themselves to build resilience.

Resources and support

You can read more about helping your child at Beyond Blue.

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

Kids Helpline offers counseling at 1800 55 1800, or email or web counselling.