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Recognizing anxiety in children and treating it successfully

As parents, we often want to shelter our children from dangerous, unnerving, or unhappy situations. There are times though that we can feel helpless, especially when it comes to something like anxiety. How, as a parent, do you recognize the signs of anxiety and how can it be successfully treated to allow our children to thrive?

Anxiety in Children

Some anxiety is normal in life. We may feel anxious when we move to a new place, begin a new job, or experience a major life change such as the death of a loved one. Children are no different.

Anxiety is part of the “fight or flight” response our bodies have to stressful situations such as taking a test, speaking publicly, or trying something new. Anxiety only indicates underlying disease when feelings become excessive and all-consuming, having a negative impact on day-to-day living. When anxiety reaches this level, it can cause overwhelming feelings of dread and fear. This can lead to physical symptoms such as a rapid heartbeat, sweating, and tension.

In children, anxiety can present itself in several ways from difficultly with eating, sleeping, and concentration to outbursts of anger or irritability. Children with anxiety may experience constant worry or have negative thoughts they can’t seem to shake. Anxiety can also cause children to feel fidgety or tense, leading to frequent trips to the restroom. They may even cry frequently and inconsolably, become clingy, or complain of general malaise, a headache orof a stomach ache.

Separation Anxiety

Starting at about six months of age, many babies experience separation anxiety. This is a fear of strangers and of being left by their primary caregiver(s). It is also common in young children up to age three. This is a normal milestone in early childhood development and most children typically outgrow it.

This type of anxiety can make it very difficult to leave young children with a childcare provider, daycare, or even other family members and friends. Parents may feel distressed or anxious leaving their child when they are anxious and crying.

To help alleviate some of the anxiety for your child, try to arrive with enough time at the caregiver’s home or daycare to spend a few moments engaged in an activity with your child before you must leave. This will help your baby or toddler focus on something fun and ease them into the transition of your absence. Explain that you will be back soon, talk about what you will do when you pick them up, and give them a kiss and hug. You may wish to leave something that smells like you such as a scarf or toy to help comfort them. After a happy farewell such as, “Have fun today. Mommy will pick you up soon. I love you,” you can leave with confidence.

Remember that when you leave your baby with another caregiver, it allows your child to grow and adapt. It’s important that you choose a caregiver that you trust because any negative interaction with the person caretaking your child can create more anxiety for the child. The caregiver should be someone who is compassionate and empathetic when it comes to your child’s anxiety. By coping with your absence, it supports your child’s healthy development and will give them the confidence to grow independently.

Social Anxiety

As children enter school and puberty, they can begin to experience social anxiety. Also known as social phobia, social anxiety is the long-term, overwhelming fear of social situations. There was an increase in social anxiety during the COVID-19 pandemic among the general public, according to The Influence of COVID-19 Pandemic on Social Anxiety: A Systemic Review which was published by the National Library of Medicine in January of this year.

Another article published in the National Library of Medicine, Narrative review: COVID-19 and pediatric anxiety, reported that “Anxiety was found to have a prevalence of 18.9 to 23.87 percent in children during the COVID-19 pandemic whereas adolescent populations demonstrated a prevalence of 15.4 to 39.9 percent. Female gender was the most studied risk factor and physical activity was the most documented preventative factor. This review supported the notion that the COVID-19 pandemic is a major contributor to anxiety in the pediatric population.”

Beyond typical shyness, social anxiety can present itself in many ways. Some symptoms of social anxiety include, but are not limited to, the following:

  • Fear that lasts throughout the day and negatively impacts daily activities such as relationships, performance in school, and self-confidence.
  • Consistent worry about and avoidance of social activities such as meeting new people, speaking on the phone, starting conversations, or even going to work.
  • Physical signs when anxious such as sweating, blushing, or appearing socially uncomfortable or incompetent.
  • Difficulty in performing in public where others may be watching for fear of judgement.
  • Avoiding eye contact, easily angered or frustrated, or becoming increasingly reliant upon parents or primary caregiver.
  • Trembling, heart pounding, or feeling sick in social situations.
  • Panic attacks caused by an overwhelming and uncontrollable sense of fear.

Some children with social anxiety may experience other mental health issues such as depression, panic disorder, or generalized anxiety disorder.

Social anxiety can have a major impact on your child, especially if it goes untreated. For some people, social anxiety can improve with age, but for many others, treatment is required in order to best manage symptoms.

Generalized Anxiety Disorder

Generalized Anxiety Disorder (GAD) is when children worry nearly every day about a variety of situations or events. This can be as simple as worrying about making a mistake on a homework assignment or everyday activities such as attending a birthday party, playtime with a friend, or even greater, uncontrollable events including the weather or the future.

Children suffering with GAD find it difficult to focus in school because they tend to always be worried about something. This makes it hard for children to relax enough to learn, have fun, eat properly, or even fall asleep at night. This extreme anxiety can lead to feelings of illness that spiral into many missed days of school.

Other anxiety disorders such as social anxiety, panic disorder, and specific phobias can lead to a GAD diagnosis. Many things can contribute to a child suffering from anxiety including genetics and brain chemistry (nature) as well as life experience and learned behavior (nurture).

Current Trends in Treating Anxiety in Children

There are several current trends in treating anxiety among children, according to the American Academy of Pediatrics. The four main treatment categories include:

  • Therapy(either individual or group therapy)
  • Therapy combined with medication
  • Medication treatment alone
  • None of the above

If social anxiety is impacting daily living for your child or teen, it’s time to seek assistance from a therapist. A mental health professional will be able to conduct a full assessment of your child. They will ask your child about their feelings, behaviors, and the symptoms they are experiencing and how their day-to-day life is being impacted. A medical professional will be able to discuss treatment options to help your child overcome their social anxiety so they can live a happy, comfortable life.

Medical treatment for social anxiety may include cognitive behavioral therapy (CBT), guided self-help, or even antidepressant medications, though these are not typically used to treat children and teens. There are also group therapy and individual therapy options.

What Parents Can Do

There are several methods parents can teach their children for coping with social anxiety. Below are several things parents can do to help their child and skills that can be taught to children to best cope with the anxiety:

  • Start by talking about the anxiety. Your child or teen can write down what they are feeling when their anxiety is triggered, what sets it off for them, and how it makes them behave as a result.
  • You can also teach breathing exercises for combating anxiety and encourage regular meditation.
  • See the social anxiety self-help guide online from the National Health Society (NHS).
  • Help your child break down social situations into smaller parts so they can then work on feeling more relaxed with each piece. For example, discuss what makes them feel anxious about going to school. Talk about what is stressful about each step and ways your child may cope with each step successfully.
  • Encourage your child to join in social situations. Arrange playdates and outings with other families with children so they can get used to meeting new people, speaking socially, and enjoying the company of others.
  • Talk to your children about times when you have felt anxious about a situation. Explain how you felt and how you overcame those feelings. Talking about your own experiences with anxiety can also allow them to open up more about their own feelings and gives them hope that it can be overcome.
  • Try not to speak for your child. Encourage them to find their own voice when others address them. This will allow them to learn to speak for themselves.
  • Avoid labeling your child as “shy” and support your child’s efforts with positive reinforcement.
  • Get moving! Physical activity and exercise are a wonderful way to fight stress and anxiety.
  • Avoid being overly critical of your child. Regardless of how frustrated you may feel about your child’s social behavior, avoid being negative or criticizing them about their anxiety, especially in public. This could make the problem worse.

Preparing for School

Parents can help prepare children for school and other social settings in advance. Start by acting out social situations at home, such as meeting a new classmate or teacher for the first time. This practice can help your child know what to say or do when the time comes.

Encourage your child, if they are old enough, to play detective by asking “What if” questions. For example, your child may express worry about being laughed at when answering a question in class. Have the child ask themselves, “What if I do answer a question? How do I know others would laugh? Is that a likely response?” You can explain that at school, all children are there to learn so the likelihood of others laughing is nil.

Let your child’s teacher know about their anxiety. This allows the teacher insider knowledge of your child in advance so they can assist them throughout the day. An understanding teacher can be a terrific source of support for your child, especially during times of high anxiety.

For more information and assistance with recognizing and treating anxiety in your child, visit or contact us via email at We are here to help you help your child in overcoming their struggle with anxiety.

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