Your child complains of a tummy ache every morning before school, but the paediatrician can't find anything wrong. Or they cry when you leave, ask a thousand 'what if...?' questions before an exam, or take ages to fall asleep because their mind keeps circling things that seem small to you. If this sounds familiar, you may well be looking at childhood anxiety, one of the most common reasons families come to see a child psychologist.
Let's be clear from the start: childhood anxiety doesn't mean you're doing something wrong as a parent, or that your child is weak. It's a normal emotion that, when it fires too much or too often, starts to shrink their world. In this article I'll explain how to recognise it, why it appears and, above all, how you can support your child at home and when it's worth seeking help.
What childhood anxiety is
Anxiety is a natural response of the body to something it perceives as a threat: the heart races, the muscles tense and the mind goes on alert. In children it works just like in adults and, in fact, it's useful: it gets them ready to react to real danger. The American Psychological Association notes that a certain amount of anxiety is part of the normal development of any child. The problem appears when that alarm switches on without a real danger, lasts too long or is so intense that it stops the child doing age-appropriate things.
Anxiety is normal: when it becomes a problem
Having fears is healthy and expected in childhood, and each age has its own: fear of the dark and of separating from parents in the youngest, monsters around four or five, and later the fear of embarrassment or failure. All of that is part of growing up. Childhood anxiety becomes a problem when the worry is out of proportion to what triggers it, keeps going week after week, causes a lot of distress and stops the child living normally. Anxiety disorders, in fact, are among the most common mental health problems according to the World Health Organization, and they often start at an early age. The line is set by the impact, not by the fact of feeling afraid.
Symptoms of childhood anxiety
Children rarely say 'I feel anxious'. Most can't yet name what they feel, which is why childhood anxiety shows up mainly through the body and behaviour. Many parents come to see me worried about one thing (tummy aches, tantrums, refusing to go to school) without suspecting that anxiety is underneath.
Signs of childhood anxiety you can watch for
- Repeated physical complaints with no medical cause: tummy aches, headaches or nausea, especially before the situations they fear.
- Sleep problems: trouble falling asleep, nightmares or wanting to sleep with you again.
- Irritability, easy tears or tantrums that seem out of proportion.
- Avoidance: not wanting to go to school, to birthday parties or to sleep over at a friend's.
- A constant need for reassurance, with repeated 'what if...?' questions.
- Trouble concentrating and a drop in school performance.
- Regressive behaviour: wetting the bed again or talking like a younger child.
The most common types of childhood anxiety
Not all fears are alike. These are the types of childhood anxiety I see most often in my practice:
- Separation anxiety: intense fear of being away from parents or home. It's the most typical in younger children, but when it's very strong it can end up preventing them from going to school or sleeping away from home.
- Social anxiety: fear of others' judgement, of speaking in class or of relating to peers; it's often mistaken for shyness.
- Specific phobias: a very marked fear of concrete things such as the dark, dogs, storms or injections.
- Generalized anxiety: constant worry about many things at once, with a permanent 'what if...?'.
- Exam anxiety: performance freezes because of the fear of failing. I cover it in depth in how to overcome exam anxiety.
Why it appears: causes of childhood anxiety
There isn't a single cause, but a mix of factors. Temperament matters: some children are more sensitive and cautious about new things from birth. Learning matters: a child who sees the adults at home worry a lot, or who gets the message that the world is a dangerous place, learns to stay on alert. And experiences matter: a change of school, the arrival of a sibling, a separation, grief or a bullying situation can switch anxiety on. Parents often tell me their child 'is fine at home': that's normal, because home is the safe place where they let out everything they've held in the rest of the day.
How it affects the child's daily life
When childhood anxiety grows, it gains ground. The child starts avoiding what scares them, and each avoidance confirms that it was dangerous, so the fear gets bigger. It can affect their sleep, appetite, concentration and grades, and also their self-esteem, because a child who feels they 'can't' ends up thinking they're less capable than others. That's why it's so important to act early, before fear shrinks their world.
Childhood anxiety and school
School is one of the settings where it shows most. Morning tears, the Sunday-evening tummy ache, refusing to go into class or fear of exams are all common signs. Sometimes there's a specific cause underneath that should always be ruled out, such as school bullying. Talking to teachers and noticing whether the fear is linked to specific moments or people helps a lot to understand what's going on. If your child is older, you may also find the teen mental health guide for parents useful.
How to help your child with childhood anxiety
The good news is that childhood anxiety responds very well when the key adults change the way they support it. The underlying idea isn't to remove all their fears, but to help them discover that they can cope with them. Your role here is one of the most powerful tools there is.
What you can do at home
- Validate what they feel, don't minimise it. Avoid 'it's nothing' or 'don't be dramatic'. A 'I understand this scares you, and I'm here with you' works much better.
- Don't help them avoid. Supporting them to face what they fear little by little (gradual exposure, step by step) is what really takes the fear away.
- Give them calming tools: breathing slowly, naming the emotion or using a soft toy or comfort object. Looking after their emotional regulation helps in the long run.
- Look after routines and sleep: predictability reassures anxious children.
- Check your own anxiety level: children imitate us, and if they see you calm they learn the situation can be handled. It may help to review these strategies to manage anxiety.
What doesn't help (even with the best intentions)
Some reactions unintentionally feed childhood anxiety. Overprotecting the child and sparing them any discomfort teaches them they aren't able to cope with anything. Answering the same question twenty times to calm them gives immediate relief, but reinforces the need for reassurance. Punishing or mocking the fear ('you're too old for this', 'don't be a baby') only adds shame to the fear they already have. And solving all their problems for them takes away the chance to discover they can manage on their own.
When to seek professional help
It's worth seeing a psychologist when childhood anxiety is intense, lasts for weeks, stops the child living normally —going to school, sleeping, relating to others— or causes a lot of distress to them or the family. The UK National Health Service (NHS) stresses that anxiety in childhood is very treatable and that asking for help early greatly improves the outlook. Booking an appointment isn't overreacting or 'medicalising' your child: it's giving them tools as soon as possible.
How child therapy helps
In child therapy we work on anxiety with the child and the family at the same time. With younger ones we do it through play, stories and age-appropriate techniques, so they learn to understand and calm their fears without being afraid of them. And with you, the parents, we work on concrete guidance to support them without reinforcing avoidance. The vast majority of cases improve a great deal. I can do this in person in Igualada or through online therapy, in English, Spanish or Catalan.
If you see that your child is suffering more than they should for their age, get in touch for a first assessment with no obligation. And hold on to this idea: childhood anxiety is very treatable, and you, as a parent, are a huge part of the solution.