As parents, it is natural to worry about your child’s wellbeing. And when anxiety takes hold, it can feel like it controls everything, your child’s life and yours too.
Having worked with anxiety in children for over twenty six years across CAMHS and private practice, I have seen how much it can take over a family. I have also seen how much difference early support makes. That is why I want to help you recognise what you are seeing, understand what is driving it, and know when to reach out.
Anxiety is one of the most common difficulties I work with. Looking back across my years in practice, around seventy percent of referrals for children have been related to anxiety in some form. And yet it often goes unrecognised and untreated for far longer than it should.
What is the difference between fear and anxiety?
Stress and anxiety are not the same thing, though they can look similar from the outside.
Stress is usually a response to something specific. A test, a friendship falling out, a change at home. When the situation resolves, the stress tends to ease with it.
Anxiety is different. It lingers beyond the trigger. It anticipates threat even when none is immediately present. A child with anxiety does not need something to be wrong right now. Their nervous system is already scanning for what might go wrong next.
Both are real and both deserve attention. But anxiety tends to need more than reassurance and time to shift.
The American Psychiatric Association puts it this way:
Fear is the emotional response to real or perceived imminent threat, whereas anxiety is anticipation of future threat. Fear is more often associated with surges of autonomic arousal necessary for fight or flight, thoughts of immediate danger, and escape behaviours. Anxiety is more often associated with muscle tension and vigilance in preparation for future danger and cautious or avoidant behaviours. (APA 2013)
In other words, fear is about now. Anxiety is about what might happen. The “what ifs”. And for many children, that anticipation of threat becomes a constant background hum that shapes everything they do.
Anxiety Symptoms in Children: What Signs to Look out For:
Physical symptoms are very real for children and teenagers. When the fight, flight or freeze response is activated, the body undergoes significant changes. Muscle tension, increased heart rate, digestion slowing down, blood redirected to the arms and legs.
This is why your child may complain of tummy aches, feeling sick, headaches, or dizziness. They may have a dry mouth, need the toilet frequently, struggle to sleep, or have changes in appetite. These are not made up. They are the body’s genuine response to perceived threat.
Excessive worry
One of the primary signs of anxiety in children is worry that feels out of proportion to the situation. Concerns about everyday things, school, friendships, future events, that surface repeatedly and are hard to reassure away.
Nighttime is often when this is worst. When distractions fall away and the mind is left with whatever it has been carrying from the day. You can read more about the link between anxiety and sleep here.
Meltdowns
Many parents are surprised when I tell them that an angry child may be struggling with anxiety. Anxiety can look like irritability, sudden tears, or meltdowns that seem out of proportion to the situation.
This is particularly common when children hold it together at school all day and then come home and fall apart. Home is where they feel safe enough to let go. It can be exhausting to be on the receiving end of that. But it is actually a sign that they trust you.
Changes in behaviour
Clinginess, separation anxiety, a need for constant reassurance. Difficulty focusing or concentrating. Seeming wired and restless, or alternatively zoned out and detached. All of these can be anxiety showing up in behaviour rather than words.
Avoidance
Children with anxiety often try to avoid whatever triggers the feeling. Social situations, school events, specific places or people. In the short term avoidance brings relief. In the longer term it maintains and strengthens the anxiety, because the child never gets the chance to discover that they could have managed.
Wanting to control
Sometimes children try to control certain areas of their lives when the world feels unpredictable and scary. They may become rigid about food, routines, or rules. They may find it very hard to compromise.
Control always feels better in the short term. But when we give in to it consistently, we can inadvertently maintain the anxiety rather than helping the child move through it.
Agitation and inability to concentrate
If a child is in a situation where they don’t feel safe, their body is primed to detect danger rather than for learning. The prefrontal cortex, responsible for rational thinking and planning, will not function efficiently. In survival mode, this part of the brain takes a back seat to the more primitive responses located in the amygdala and limbic system. The child’s body prepares to fight or flee, rather than sit calmly, and learn. This can result in restlessness, difficulty concentrating, and being easily distracted. Younger children may appear constantly on the go, all over the place, wired and unable to focus on one task. Older children may also display these behaviours, or seem “ zoned out” and detached. My article on, What if not all Attention Difficulties may be ADHD, includes more details on how restlessness and lack of focus can be misconstrued as ADHD.
A note in trauma
Sometimes what looks like ordinary anxiety is actually something deeper. If your child’s anxiety followed a specific frightening event, a hospital stay, a loss, an accident, or if it’s part of a wider pattern that’s been building for a long time, it’s worth reading my page on Trauma: Signs, Symptoms and Support alongside this one. Anxiety and trauma can look very similar from the outside, and many parents don’t immediately realise trauma might be part of the picture.
A final thought
Anxiety is not a character flaw. It is not bad parenting. It is a nervous system doing what it was designed to do, trying to keep your child safe in a world that sometimes feels overwhelming.
With the right support, children learn to manage it. They discover they are more capable than the anxiety tells them. And that changes everything.
When thinking about whether to seek help, I find it useful to consider three things.
When to seek support: the three Ds
Distress. How much is your child suffering? How severe and how frequent are the symptoms?
Duration. How long has this been going on? Anxiety that has persisted for six months or more and is not shifting is worth taking seriously.
Disruption. Is it affecting daily life? School, friendships, activities they used to love, the ability to function in ordinary situations?
If all three are present, please do reach out. It is not true that children will naturally grow out of anxiety. And early support makes an enormous difference.
Interested in working with me?
If you are worried about your child, I would love to hear from you. I offer one to one therapy for children and young people, therapeutic support for parents, and training and consultation for schools and professionals.
You can get in touch via my contact page.
And if you would like free resources and occasional guidance straight to your inbox, you are very welcome to join my newsletter. I do not send many emails. Just things I think are worth your time.
With warmth,
Catherine
Free resources
Understanding Your Child’s Guard Dog Brain explains what is happening in your child’s nervous system when anxiety takes over.
Holding in the Storm is about staying steady as a parent in the hard moments.
When Darkness Comes for support with anxiety and sleep difficulties at night.
All free to download.
Related reading
Talking Helps: Explaining Anxiety to Children
Anxiety Disorders in Children: Understanding the Six Types
Does My Child Have Separation Anxiety?
Beyond Don’t Worry: Why Reassurance Is Not Enough
Understanding the Link Between Sleep Problems and Nighttime Fears
