How can you recognise anxiety in children? This guide covers signs by age, causes, steps you can take at home and when it is time to seek professional support.
If your child often says their tummy hurts, won't let go of your hand before walking into a new place, or asks "What if something happens?" over and over before bed, anxiety may be behind it. Anxiety in children can appear as a natural part of development, but sometimes it reaches a level that makes everyday life, school and friendships difficult. The good news is that anxiety is a feeling children can learn to cope with, once it is properly understood and parents' responses are adjusted thoughtfully. In this article we look step by step at how anxiety shows up in children, what feeds it, what you can do at home, and when it helps to consult a specialist.
What Is Anxiety in Children?
Anxiety is an alarm system in the brain that prepares us for possible danger. When it switches on, the heart beats faster, breathing quickens, muscles tense and attention turns towards signs of threat. For adults and children alike, this response is there to protect us. The problem arises when the alarm goes off frequently and loudly even though there is no real danger.
Children's anxiety can look different from that of adults. An adult can say "I'm worried", but a young child may express it through crying, anger, clinging or physical complaints. This is because children's skills in naming and regulating emotions are still developing. That is why it is so important for parents to learn to read the feeling underneath the behaviour.
Every age has its own expected fears. Stranger anxiety in infancy, fear of the dark and monsters in the preschool years, and worries about failure and being left out by peers in primary school are all common developmentally. These age-appropriate fears usually fade on their own as the child grows, especially in a supportive environment. To tell whether anxiety has become a "problem", what matters is its intensity, how long it lasts and how much it restricts the child's life.
What Are the Signs of Anxiety in Children?
Anxiety shows itself in three areas: in the body, in thoughts and in behaviour. None of the signs below amounts to a diagnosis on its own, but they are worth paying attention to when they appear together and last for a long time.
Physical signs
- Stomach ache, nausea or headaches, especially on school mornings or before a new situation
- Difficulty falling asleep, frequent waking at night, nightmares
- A marked decrease or increase in appetite
- Frequent urges to go to the toilet, sweating, trembling
- A constant state of tiredness and tension
With complaints like these, it is first necessary to make sure through a paediatrician's assessment that there is no medical cause. When no medical cause is found, physical symptoms can be the language of anxiety.
Signs in thoughts and feelings
- Frequently repeated "what if" questions such as "What if Mum doesn't come home?" or "What if everyone laughs at me in class?"
- Being extremely afraid of making mistakes, trying to be perfect
- Constantly asking for reassurance ("Are you sure? Promise?")
- Believing that events heard on the news will happen to them
- Crying easily, becoming irritable quickly, restlessness
Signs in behaviour
- Avoiding feared situations: not going to a birthday party, not raising a hand in class, not staying alone in a room
- Difficulty separating from parents, clinging
- Refusing to try new foods, games or places
- Sudden outbursts of anger, especially when faced with an anxiety-provoking situation
- Repetitive behaviours such as nail biting or hair pulling
How it looks at different ages
Ages 3–6: Crying and clinging at separation, fear of the dark and imaginary creatures, and regressive behaviours (bedwetting, baby talk) are more common.
Ages 7–11: Worries about school performance, friendships, health and the safety of family members come to the fore. Physical complaints and reluctance to go to school may increase.
Age 12 and over: Fear of social judgement, appearance, exams and the future becomes more prominent. A teenager may withdraw into themselves or take refuge in screens.
What Causes Anxiety in Children?
Anxiety has no single cause; usually several factors come together.
Temperament: Some children are born more cautious and slower to adapt to novelty. This is not a flaw but a trait; however, it can increase the need for support.
Anxiety patterns in the family: Children learn largely by watching their parents how to interpret the world. If a parent constantly issues warnings about danger or voices their own anxiety out loud, the child may come to see the world as a dangerous place.
Overprotective parenting: Shielding a child from every difficulty may seem comforting in the short term, but it prevents the child from having the experience of "I can handle this". We discuss this in detail in our article on overprotective parenting.
Life events: Changes such as moving house, changing schools, the birth of a sibling, divorce, the loss of a loved one, illness or migration can trigger anxiety. After the 6 February 2023 earthquakes in Turkey, specialists frequently reported sleep problems and safety-related anxiety in many children, even those who had not directly experienced the quake.
Academic pressure: An early start to private courses and exam preparation, and the weight that exams such as the LGS (Turkey's national high-school entrance exam) carry within the family, can feed fear of failure in children.
The Impact of Anxiety on Daily Life
When anxiety in children goes unsupported, its most defining feature is that it gradually narrows the child's world. Every avoided situation brings short-term relief, and that relief teaches the brain that "running away worked". Over time the child tries fewer things and feels comfortable in fewer places.
Imagine an eight-year-old who wakes every morning with a stomach ache because they are afraid of reading aloud in class. The parent keeps them at home for a few days. The child feels relieved, but returning to school becomes even harder, because now both reading aloud and the missed lessons are sources of worry. This cycle is a typical example of how anxiety feeds itself. In some cases the process can end in school refusal.
Anxiety also affects family life: mornings become tense, evening routines drag on, and siblings may feel neglected. Parents may feel helpless or guilty. These feelings are completely understandable, and focusing on finding solutions rather than assigning blame helps everyone.
Parenting Approach: What Can You Do at Home?
Parents are the strongest allies in a child's learning to cope with anxiety. Anxiety in children often eases through small but consistent changes at home. The steps below can be adapted for both younger and older children.
1. Accept the feeling, don't dismiss it
Saying "There's nothing to be afraid of" is well meant, but it can send the child the message that their feeling is wrong. Instead you might try: "I can see you're worried about giving your presentation at school tomorrow. That's completely understandable." When a feeling is named, the child feels understood and finds it easier to calm down.
2. Limit reassurance
Constantly saying "I promise, nothing will happen" soothes for a short while, but the child will need reassurance again next time. Give one clear, calm answer, then invite the child to think about their own ways of coping: "We talked about this before. What do you think you could do when the worry comes?"
3. Small steps instead of avoidance
The remedy for anxiety is to approach the feared situation gradually and safely. You can think of it as a ladder:
- Together with your child, break the feared situation into small steps, from easiest to hardest.
- For example, for a fear of parties: talking about the party, going to the party together for a short while, playing while a parent is nearby, the parent stepping out for a while, staying for the whole party.
- Repeat each step until your child feels clearly more at ease at that step.
- Praise the effort, not the outcome: "You were scared, but you walked in anyway. That is courage."
4. Teach body-calming skills
- Ages 3–6: The "balloon breath" game: slowly inflate and deflate your tummy like a balloon. Tense and relax the muscles with the "turtle going into its shell" game.
- Ages 7–11: Square breathing (breathe in for four, hold for four, breathe out for four, pause for four). Drawing the worry on a piece of paper and putting it in a "worry box".
- Age 12 and over: Writing down anxious thoughts and reviewing them with the questions "How likely is this to happen? If it did, what could I do?"
Practise these skills like a game in calm moments, not during moments of anxiety; that way they become usable in difficult moments.
5. Set a worry time
For school-age children in particular, a 10–15 minute "worry time" each day can be useful. Worries that come up during the day are put off until this time, and are talked through together at that hour. This method helps limit anxiety from spreading across the whole day.
6. Notice your own anxiety
Children learn from what parents do far more than from what they say. When managing your own anxiety, thinking aloud can be a good model: "The traffic is really heavy, so we'll be a little late. I've got tense, but I'm going to take a deep breath and message the teacher." If your own anxiety is intense, getting support for it is a valuable step for your child as well.
7. Provide routine and predictability
Regular sleep times, a calm evening routine, limited screen time and telling your child about changes in advance all help reduce anxiety. Planning together "What will happen tomorrow?" before a new situation gives the child a sense of control.
8. Work with the school
Anxiety often shows up at school too. Talking with the teacher and the school counselling service and sharing the moments your child struggles with ensures the same approach is used at home and at school. For example, for a child who shies away from reading aloud, steps can be planned together: first reading just a short sentence to the teacher, then reading in a small group. A consistent approach makes it easier for the child to feel safe.
The goal is not for the child never to feel anxious, but for them to believe they can cope with it when it comes.
When Should You Seek Professional Support?
Not every worry requires therapy. However, it can be helpful to consult a mental health professional who works with children and adolescents in the following situations:
- If the anxiety has lasted several weeks and is gradually increasing
- If the child has clear difficulty going to school, making friends or taking part in age-appropriate activities
- If sleep, appetite and physical complaints are seriously affecting family life
- If the methods tried at home are not working and tension in the family is increasing instead
- If the child seems constantly unhappy or hopeless, or talks about hurting themselves (in an emergency, call 112, Turkey's emergency services)
- If symptoms persist for a long time after a traumatic event
For a more detailed framework on when to seek help, you can read our article on when to take your child to a child psychologist. If the question of medication comes up during assessment, that decision belongs to a child and adolescent psychiatrist.
How Is Anxiety in Children Addressed in Therapy?
When working with anxiety in children, the approach is determined by the child's age and developmental level. The first sessions are usually held with the parents; the child's developmental history, when and how the anxiety began, and what the family has tried so far are discussed.
Play therapy: Young children express their feelings through play far more than through words. In child-centred play therapy, the child expresses their fears through play within a safe relationship and experiences gaining a sense of control over them. You can find out how this process works on our child and play therapy page.
Cognitive behavioural therapy (CBT): This is one of the approaches supported by research for working with anxiety in school-age children and adolescents. Through age-appropriate activities, the child learns to notice anxious thoughts, test them, calm the body and gradually approach feared situations.
Work with parents: An important part of therapy is the sessions held with parents. Recognising cycles of reassurance and avoidance and planning together the steps to be applied at home strengthens the process.
When it is considered necessary, aids such as children's drawings can help in understanding the child's inner world; however, these are not used on their own to make a diagnosis.
Frequently Asked Questions
Does anxiety in children go away on its own?
Most age-appropriate fears fade as the child grows and in a supportive environment. However, if anxiety is fed by avoidance, it can increase over time. If symptoms have lasted for weeks and are limiting daily life, it is helpful to speak with a specialist.
Is it right to push an anxious child?
There is a difference between pushing and encouraging. Rather than throwing the child suddenly into the most feared situation, it is healthier to move forward in small, manageable steps and to support each one.
How can you tell anxiety from laziness or stubbornness?
An anxious child usually cannot do something even though they want to; physical symptoms, intense tension and "what if" thoughts accompany it. Being curious about the feeling behind the behaviour and asking "What is hardest for you?" makes the distinction easier.
Are online sessions suitable for children?
Sessions with parents can be held effectively online. For working directly with young children, a face-to-face play room is often preferred; for teenagers, online sessions can be a good option. The most suitable format is decided together at the first assessment.
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Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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