Childhood anxiety: how to spot it and support your child

Your son complains of a tummy ache almost every school morning. Your daughter hasn't wanted to sleep alone for weeks, or bursts into tears over something that seems tiny to you. And you, caught between worry and exhaustion, wonder whether it's just a phase, whether you're doing something wrong, or whether you should ask for help.

If this sounds familiar, take a breath: you are not alone. Anxiety in childhood is far more common than people think and, above all, it is very treatable once it is properly understood. In this article we explain how it presents in children, what keeps it going, what you can do at home and when it is a good idea to seek a consultation.

What anxiety is and why a certain level is normal

Anxiety is the body's natural response to something we perceive as a threat or a challenge. It activates the heart, the breathing and the muscles to prepare us to act. In essence, it is an alarm system, and thanks to it we learn to be careful, to prepare for an exam or to keep away from the edge of a cliff.

That is why feeling fear or nerves is part of healthy development. A boy who gets restless before his first day at school or a girl who worries about an oral presentation has no problem at all: their alarm is working.

Anxiety becomes a difficulty when the alarm goes off too often, too intensely or in situations that pose no real danger, and when it starts to limit the life of the child or the family. The key is not how much anxiety your child feels, but how much it stops them doing what is expected for their age: going to class, playing, sleeping, being with friends.

How anxiety shows up in children

We adults usually describe anxiety with words: "I'm overwhelmed", "I'm worried that…". Children, on the other hand, rarely have the vocabulary to explain what they feel, so their anxiety tends to speak through the body and through behaviour. This means it often goes unnoticed or gets mistaken for bad manners, laziness or "a strong character".

In session we often see these ways of expressing it:

• Physical complaints: tummy aches, headaches, nausea, needing the toilet frequently or a feeling of breathlessness, with no clear medical cause.
• Irritability and tantrums: disproportionate outbursts of anger or crying, especially at moments of transition (leaving the house, doing homework, going to bed).
• Avoidance behaviours: refusing to go to school, on an outing or to a birthday party, or to stay with another person.
• Sleep problems: difficulty falling asleep, waking in the night, nightmares or needing company to sleep.
• Excessive attachment: not wanting to leave their parents, following them around the house, needing to know where they are at all times.
• Repeated questions: constantly seeking reassurance with a "what if something happens?" that never quite settles.
• Regressions: going back to behaviours from earlier stages, such as thumb-sucking, wetting the bed at night or talking like a baby.

None of these signs, on its own, means there is a disorder. What guides us is the whole picture, how long it lasts and its impact on day-to-day life.

Typical fears by age

Many fears are to be expected at certain stages and disappear on their own over time with the right support. Knowing about them helps you avoid worrying more than necessary:

• From 0 to 2 years: fear of strangers and of separating from attachment figures, as well as loud noises.
• From 3 to 5 years: fear of the dark, monsters, costumes, animals or being left alone. Imagination grows faster than the ability to tell what is real from what is make-believe.
• From 6 to 9 years: fear of storms, of something happening to their parents, of doctors, of making a fool of themselves or of being laughed at.
• From 10 to 12 years: worry about school performance, acceptance by the group, their own health and that of their family, or what they see in the news.
• In adolescence: concern about body image, the future, relationships and fitting in socially.

Why it appears: causes and the factors that keep it going

There is no single cause. The evidence suggests that childhood anxiety arises from a combination of several factors:

• Temperament: some children are born more sensitive, cautious or reactive to anything new. It isn't a flaw; it is a trait that needs to be understood.
• Heredity and family environment: anxiety tends to run in families, partly because of genetics and partly because children learn to interpret the world by watching adults.
• Stressful experiences: a house move, a change of school, a separation, a bereavement, an illness or difficulties with classmates.

Beyond what causes it, there is what keeps it going. And here is something important we want to tell you with great warmth and with no intention of blaming anyone: the mechanism that feeds anxiety the most is avoidance.

The cycle of avoidance and overprotection

When we see our child suffering, our instinct is to protect them and take the discomfort away as soon as possible. It is deeply human and it comes from love. If they are afraid to speak in class, we excuse them. If they don't want to go to the party, we stay at home. If they can't sleep alone, we lie down with them.

In the short term it works: the distress drops and we all breathe again. The problem is the message the child receives without meaning to: "that was dangerous, and it's a good thing you didn't face it". The brain learns that escaping is what saves it, so the next time the fear will be the same or greater, and their world will gradually become smaller and smaller.

Soothing by avoiding is an understandable impulse, not a parenting mistake. Almost all mothers and fathers do it at some point. The good news is that once we see it, we can change the strategy: instead of clearing the fear out of the way, we can accompany the child through it, little by little.

Warning signs: when to seek a consultation

We recommend asking for a professional assessment if you notice any of these situations:

• The distress lasts several weeks and doesn't improve despite your support.
• It interferes with everyday life: missed school days, refusing activities they used to enjoy, losing friendships.
• Sleep or eating problems persist.
• Physical complaints are frequent, or there are panic attacks, with palpitations, a feeling of breathlessness or intense fear of losing control.
• Repetitive rituals or checking appear that the child feels they cannot stop.
• They seem sad or apathetic, withdraw from others or say things like "I'm no good at anything". If at any point they talk about hurting themselves or not wanting to live, ask for help without waiting.
• The whole family organises itself around the child's fear and family life suffers.

An important note: when there are persistent physical symptoms, such as repeated tummy aches or headaches, the first step is to see the paediatrician to rule out medical causes. If everything is fine, we can then think more calmly about the emotional side. The two approaches complement each other.

What does help at home

You are the most important figure in your child's emotional regulation. You don't need to do it perfectly: a few simple guidelines, kept up over time, are enough.

Validate without minimising or magnifying

Avoid phrases like "it's nothing" or "don't be silly", which make them feel that their emotion isn't valid. But don't amplify it either with a "poor thing, how awful". Try something in between: "I understand you're scared, it's normal to feel that way. I'm here and we'll work out how to do it together". Putting a name to the emotion already reduces it.

Support gradual exposure instead of avoidance

Break down whatever frightens them into small steps and move forward one at a time. If they are afraid of sleeping alone, you can start by sitting next to them, then at the door, then with the door ajar. Celebrate every step, however small. What matters is that the child understands they can feel afraid and still do it, and that anxiety goes down on its own with time.

Keep routines predictable

Steady schedules for sleep, meals and homework offer security. Anticipating changes calmly ("tomorrow we're going to the dentist, let me tell you what it will be like") reduces uncertainty, which is a major fuel for anxiety.

Model calm by your example

Children copy how we handle stress. If you get overwhelmed too, that's fine: you can say out loud "I'm feeling nervous, I'm going to take a deep breath for a moment". You are showing them that emotions can be managed. Looking after your own wellbeing isn't selfish; it is also a way of helping your child.

Look after screens, news and rest

• Limit screen time, especially before bed, because it affects sleep and mood.
• Filter the news and any violent or catastrophic content, which can feed the fears of the youngest children.
• Protect a daily block of free play, movement and time outdoors: it is a natural stress regulator.

How child therapy works

You may be wondering what a session is like with a young child who can't explain what is happening to them. Child therapy doesn't mean the child sits and talks for an hour: it adapts to their age and their natural language, which is play.

Through drawings, stories, puppets and games, the child expresses what they feel, learns to recognise their body's signals and practises simple tools, such as breathing, calming strategies or different ways of talking to themselves. With older children and adolescents, the work is more conversational and draws on cognitive-behavioural techniques that have good evidence in anxiety.

An essential element is the family. We work with you so that you understand what is keeping the problem going and learn specific guidelines, such as supporting gradual exposure or responding to requests for reassurance without reinforcing the fear.

When to see a professional

There is no need to wait until the situation is serious. Seeking help early doesn't mean something is very wrong; it means you want to understand your child better and give them tools in good time. A first assessment helps clarify whether what you are seeing is within what is expected, gives you guidelines and, if necessary, proposes a course of therapy.

A final message of hope

Anxiety in childhood is one of the emotional difficulties that responds best to early intervention. An anxious child is not a fragile child: they are a sensitive child who needs to learn to manage an alarm that is too sensitive, and they can achieve it with your support and, if needed, the help of a professional.

Start today with something simple: put a name to what you feel, validate what your child feels and offer them one small step they can take. If you notice that the situation is overwhelming you or isn't improving, booking an assessment consultation can make all the difference. You don't have to walk this road alone.

If you want to keep reading, our article on tantrums in children may help you. And if you feel you could use professional support, you can see how we approach child psychology.