Recognising Anxiety in Children
Anxiety is a normal part of being human. It forms part of the body’s natural “alarm system” that helps us stay safe. When something feels threatening, this system prepares the body to respond. According to Lang’s three-systems model of anxiety, anxiety shows itself in three main ways: through emotions, physical reactions in the body, and behaviour.
This is especially important to understand in children. Children do not always have the words to explain how they feel. Instead, their anxiety often shows up in what they do, how their bodies react, and how they express their emotions.
Let’s look at these different ways anxiety can appear.
Emotional signs
Parents may notice that a child becomes more emotionally reactive. This can include frequent crying, becoming easily overwhelmed, or struggling to cope with everyday situations (Wang et al., 2017). Anxiety in children does not always look like fear. It can also appear as irritability, frustration, or even anger (American Psychiatric Association, 2013).
Some children may have emotional outbursts, especially when their anxiety becomes too much to manage (Beesdo et al., 2009). Ongoing or excessive worry is also common (American Psychiatric Association, 2013; Wang et al., 2017), particularly worry about future events or “what might happen” (Kendall et al., 2010).
Physical signs
Children are often very aware of what is happening in their bodies. They may notice changes such as a racing heart or feeling shaky, but not understand why it is happening. Sometimes, they may think these sensations mean something is wrong, which can make their anxiety feel even worse (Muris et al., 2004).
Common physical symptoms of anxiety include headaches, stomach aches, nausea, dizziness, sweating, blushing, fast breathing, heart palpitations, shakiness, tiredness, and sleep difficulties.
Behavioural signs
Anxiety often shows up in behaviour. One of the most common patterns is avoidance. A child may try to stay away from situations that make them feel anxious. While this can reduce fear in the short term, it can actually keep the anxiety going over time. This is because the child does not get the chance to learn that they can cope with the situation.
Other behaviours may include constantly seeking reassurance (Kendall et al., 2010), becoming very distressed when separating from caregivers (American Psychiatric Association, 2013), or showing increased tearfulness and clinginess.
Why early support matters
Recognising these signs early can make a meaningful difference. When anxiety is identified and supported early, children are more likely to develop healthy coping skills and feel more confident in managing challenges. Research shows that early intervention can reduce the long-term impact of anxiety and improve overall functioning (Beesdo et al., 2009).
Support does not need to be overwhelming. Wit the right guidance, and in small, consistent steps children can learn that while anxiety is uncomfortable, it is manageable, and they are capable of coping.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
Beesdo, K., Knappe, S., & Pine, D. S. (2009). Anxiety and anxiety disorders in children and adolescents: Developmental issues and implications for DSM-V. Psychiatric Clinics of North America, 32(3), 483–524. https://doi.org/10.1016/j.psc.2009.06.002
Kendall, P. C., Compton, S. N., Walkup, J. T., Birmaher, B., Albano, A. M., Sherrill, J., … Piacentini, J. (2010). Clinical characteristics of anxiety disordered youth. Journal of Anxiety Disorders, 24(3), 360–365. https://doi.org/10.1016/j.janxdis.2010.01.009
Lang, P. J. (1971). The application of psychophysiological methods to the study of psychotherapy and behavior change. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy and behavior change (pp. 75–125).
Muris, P., Merckelbach, H., Schmidt, H., & Tierney, S. (2004). Anxiety sensitivity, cognitive biases, and anxiety symptoms in children. Journal of Psychopathology and Behavioral Assessment, 26(2), 77–87. https://doi.org/10.1023/B:JOBA.0000013662.41899.29 Wang, Z., Whiteside, S. P., Sim, L., Farah, W., Morrow, A. S., Alsawas, M., … Murad, M. H. (2017). Comparative effectiveness and safety of cognitive behavioral therapy and pharmacotherapy for childhood anxiety disorders. Journal of Clinical Child & Adolescent Psychology, 46(5), 647–660. https://doi.org/10.1080/15374416.2016.1152556
