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Anxiety in Children – Causes, Symptoms, Treatments

Article Overview

  1. What is childhood anxiety?
  2. What causes childhood anxiety?
  3. When to worry about childhood anxiety?
  4. Child anxiety symptoms checklist

Anxious Kids: Free Childhood Anxiety Symptoms Checklist

What is Childhood Anxiety?

Childhood Anxiety refers to thought and behavioural issues that result from excessive fear and worry in children. Fear is best described as an emotional response to a real or perceived threat, whereas worry focuses on the anticipation of a future threat. Anxiety disorders are one of the most common mental health concerns in the world and can become debilitating if left untreated [1]. The most common types of anxiety disorders are phobias, social anxiety disorder, generalized anxiety disorder and panic disorder.

Anxiety is our body’s natural response to fearful situations and is simply a characteristic of being human. If anxiety didn’t exist, people would likely struggle to anticipate and avoid danger. According to Ronald Siegal, a clinical professor of psychology at Harvard Medical School, “anxiety is another word for fear, and fear is essential for survival” [2]. However for some children, like my daughter, anxiety can be constant and so severe that it can begin to have an impact on many areas of their lives. 

Approximately 1/3 of adolescents have a formal diagnosis of anxiety and even children under 6 years of age can experience feelings of anxiety. In fact, roughly  20% of visits to a pediatrician’s office  are due to behavioural issues and many of these children have anxiety [3]. 

Many children with anxiety have a heightened response to stress. I remember when Chanel attended preschool; she would have difficulty playing and forming friendships with the other children. Often, she would cling to me and need me within sight continuously. At the time, I dismissed her behaviour as clingy, her pediatrician classified her behaviour as a form of separation anxiety that she would eventually outgrow. Family members thought I was spoiling her and offered their fair share of advice to help her become more independent. In hindsight, it’s clear to me now that she was just scared, but her body’s attempt to feel safe manifested itself as negative behaviours.

What Causes Childhood Anxiety? 

The Fight, Flight, or Freeze response

Symptoms of anxiety, such as clammy hands, dry mouth, stomach aches etc. are the result of the “fight, flight or freeze” response. This is one of our bodies’ defence mechanisms designed to keep us safe. There are several triggers that can initiate this response such as being tired, hungry, and too hot or too cold, being nervous about an exam or new social environments. The fight, flight, or freeze response is triggered by the amygdala, which is part of the limbic system and is designed to recognize danger and prepare our body to react to it. When it’s working properly, the amygdala transmits signals only when there is a real threat. However, for some children, the system misfires and transmits false alarms, sending them into full blown fight, flight or freeze mode weekly, daily or even multiple times a day. 

“Fight” can look like:

  • being defiant 
  • argumentative
  • hitting other children
  • kicking
  • screaming
  • spitting
  • pushing
  • throwing anything he can get his hands on
  • his hands clasped in fists, ready to punch
  • glaring
  • clawing at the air
  • gasping for breath

“Flight” can look like:

  • withdrawal
  • refusal to participate
  • darting eyes
  • restlessness
  • excessive fidgeting
  • doing anything to get away
  • running without concern for his own safety

“Freeze” can look like:

  • holding their breath
  • heart pounding and/or decreased heart rate
  • shutting down
  • feeling unable to move
  • escaping into his own mind
  • feeling numb
  • whining
  • daydreaming

The “fight, flight, or freeze response is designed to protect us from danger. But in children with anxiety, the “fight, flight, or freeze” response is on overdrive and easily triggered. The response is activated even when there is not an imminent threat, which leads to the release of chemicals that prepare their bodies to deal with fearful situations. 

Other Factors that Can Create Anxiety in Children

Genetics – Genetics appears to be a factor when it comes to childhood anxiety. According to kidshealth.org, children who display anxious tendencies are likely to have relatives who have an anxiety disorder. Children may inherit genes that make them more susceptible to anxiety. A study conducted by the Washington School of Medicine concluded that early signs of anxiety and depression may be present in newborn babies. Brain scans of these newborns revealed that the “strength and pattern of connections between certain brain regions” were indicators as to whether or not the baby was prone to developing shyness, nervousness, separation anxiety or excessive sadness [4].

Brain Chemistry – Certain genes are responsible for regulating chemicals that are released in the brain. These chemicals are known as neurotransmitters. If there is an imbalance of these chemicals, not enough, or a malfunction, the child can also experience anxiety.

Trauma- Children who may have had a difficult upbringing or may have experienced traumatic events can also have difficulty coping with life’s stressors. The death of a loved one, abuse, violence or other challenging situations can create an anxious child.

Learned Behaviours – Being around other people who fear certain things or experiences can also create a form of contagion that can actually “teach” a child to be anxious. 

When to Worry About Child Anxiety? 

After having many sessions with therapists and doctors, in regards to Chanel, the consensus for whether or not you should seek professional advice about a child’s behaviour, has a lot to do with whether or not their behaviour is impacting several areas of their lives and its severity. In other words, if the behaviours you’re noticing are occurring outside of your home, in numerous environments, and consistently, it might be time to book an appointment with your pediatrician. Chanel’s tantrums and fears began to spill over into school, play dates, birthday parties and other settings outside of our home. Dr. Stacey Belanger, pediatrician in developmental medicine at Saint-Justine Hospital in Montreal, states that parents need to be able to distinguish between normal developmental fears versus an anxiety disorder. Normal developmental fears are usually short term and the child outgrows the behaviour. As opposed to anxiety disorders which are chronic and intrusive [5].

Here are some factors to consider when distinguishing between an anxiety disorder and ordinary fear.

  • Severe anxiety creates unrealistic beliefs.
    A child who is learning to ice skate might worry about falling and getting hurt. A child with obsessive-compulsive disorder might worry about the same thing, even if they don’t own a pair of skates.
  • Severe anxiety leads to exaggeration of situations.
    A college student in their final year might stress about finding a job after graduating. A child with generalized anxiety disorder might constantly worry about finding a job after graduating, even though they are only in grade 5. 
  • Severe anxiety makes children feel overly self-conscious.
    A student might feel nervous about doing a presentation in front of their peers. However, a student with social anxiety disorder might avoid asking for help from their teacher because they are afraid of being embarrassed.
  • Severe anxiety is often unwanted and uncontrollable.
    A young child might cry at school because they miss their mother. A child with separation anxiety might cry at school because they believe that something bad will happen to their mother if they are away from her. 
  • Severe anxiety doesn’t go away.
    While anxiety symptoms are common and even expected after a disturbing experience, over time most children bounce back from them. Three months later a child with post-traumatic stress disorder will still be having nightmares.
  • Severe anxiety leads to avoidance.
    A child might be nervous about going to an amusement park for the first time. A child with a specific phobia of loud noises might avoid amusement parks completely because of the noises they might encounter [6].

When we notice anxious behaviours in a child, we often think that they will outgrow them or that they will go away on their own. I assumed this would happen with Chanel and I even consulted with medical professionals who thought the issues would resolve themselves. But they didn’t. So, if you notice that their anxious behaviours are increasing in frequency and intensity, it’s important to get help. 

Child Anxiety Symptoms Checklist

I’ve compiled a child anxiety symptoms checklist for you to use as a tool to monitor the behaviours of your child. First and foremost, I am not a medical professional but I am the proud mother of an anxious child. I’ve created a tool that I wish that I had when we were trying to get to the root of Chanel’s behavioural issues. This checklist gives you an overview of some of the most common and noticeable symptoms. I also recommend that you monitor these behaviours over the span of a week at least, so that when you have a discussion with your family doctor or pediatrician, you can show them that the behaviours are consistent.

Click HERE to download your free childhood anxiety symptoms checklist

Next Steps 

If you are noticing anxious behaviours in your child that seem to be increasing in severity or frequency please seek help from a medical professional. You can use the checklist I’ve provided to record your observations and share any other anecdotal notes, from educators, child care providers etc. with your doctor as well. The more information you provide them with, the more informed their decision will be when making their recommendations. 

As well, please don’t be afraid to seek advice from several medical professionals. We had 2 doctors tell us that Chanel would eventually outgrow her anxious tendencies. You know your child best and if you feel like their behaviours might be a cry for help, keep searching until you find the help they need. Remember, as a parent or educator, your goal is not to eliminate all anxiety from their life. Rather, your job is to help them learn how to manage their anxiety, so that they can deal with life’s challenges effectively.

Anxiety is a natural part of life, but it shouldn’t restrict or hinder the success of our children. Please let me know what strategies or therapies that you’ve used to help your child manage their anxiety. 


  1. Abbing, A. C., Baars, E. W., Van Haastrecht, O., & Ponstein, A. S. (2019, December 28). Acceptance of Anxiety through Art Therapy: A Case Report Exploring How Anthroposophic Art Therapy Addresses Emotion Regulation and Executive Functioning. Retrieved from https://www.hindawi.com/journals/crips/2019/4875381/
  1. Ibid
  1. Dr. Alina OlteanuDr. Alina Olteanu is the founder of Whole Child Texas. (2020, August 16). Childhood Anxiety: Diagnosis & Natural Treatment Options. Retrieved from https://www.greenchildmagazine.com/childhood-anxiety-natural-treatment-options/
  1. WUSTLmed. (2017, February 01). Early signs of anxiety, depression may be evident in newborns. Retrieved from https://www.eurekalert.org/pub_releases/2017-02/wuso-eso020117.php
  1. WUSTLmed. (2017, February 01). Early signs of anxiety, depression may be evident in newborns. Retrieved from https://www.eurekalert.org/pub_releases/2017-02/wuso-eso020117.php
  2. Rachel Ehmke is managing editor at the Child Mind Institute. (2019, January 29). When to Worry About an Anxious Child. Retrieved from https://childmind.org/article/when-to-worry-about-an-anxious-child/


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