Estimated reading time: 12 minutes
Anxiety in children is different than anxiety in adults, and why is that? Well, kids show more behavioral symptoms than adults do because they just don’t have the words to connect what their body is telling them with how they’re actually feeling. With children, they often display physical symptoms of anxiety. These symptoms can wax and wane, as well as show up at different points.
What are the most common signs and symptoms of anxiety in children?
Children often communicate anxiety through behavior—behavior is communication. You might see:
- Excessive worry or rumination, especially about future events or what others think.
- Frequent meltdowns, irritability or emotional lability: they go from calm to upset quickly.
- Avoidance: refusing school, new experiences, or social situations.
- Need for reassurance: repeatedly asking “Are you sure?” or “Will you stay?”
- Perfectionism, rituals or rigid routines.
- Sensory sensitivities: light, noise, taste, smell trigger distress.
- Fear, phobias, or separation anxiety typical in younger children who cling or resist leaving caregivers.
This is the core of the signs and symptoms of anxiety in children, and air‑tight confirmation that their brain is in survival mode—not just misbehaving.
How can anxiety show up physically and behaviorally?
Anxiety frequently hides in the body. Many children don’t say, “I feel worried”—instead they complain of:
Physical symptoms
- Headaches, stomachaches, nausea, or unexplained aches
- Difficulty sleeping, nightmares, or frequent waking
- Muscle tension, sweaty palms, or frequent urination
Behavioral signs
- Loss of appetite, nail‑biting, hair pulling
- Tantrums or rage over perceived small triggers
- School refusal behavior—fear of going to school despite good health
What triggers are behind childhood anxiety?
Anxiety doesn’t need a big event—it builds in small daily stressors:
- Sensory overload: scratchy uniforms, loud classrooms, fluorescent lights
- Transitions and unpredictability: sudden changes to routine or surprises
- Social pressure: fear of judgment, fitting in, or speaking up
- Academic expectations: test anxiety, perfectionism
- Family stress: modeled worry, emotional tension in the home
Example:
Grace, mom of 10‑year‑old Aria, noticed that Aria’s meltdown would follow a school art project due to strong paint smells and bright lights. What seemed like a “creative block” was sensory-triggered anxiety. Once the trigger was addressed, Aria’s anxiety dropped significantly.
Why does anxiety often get mistaken for ADHD or behavior issues?
Anxiety and ADHD‑like symptoms can look similar:
- Kids in chronic worry loop can’t focus—looks like inattention or impulsivity
- Emotional dysregulation can appear as defiance, flaring tempers, or oppositional behavior.
As I often say: it’s not bad parenting—it’s a dysregulated brain. Anxiety is sometimes hidden behind hyperactivity or rage—and without tools, gets labeled incorrectly.
Real-life story of a client who visited our clinic:
A pre‑teen who seemed defiant at school, actually struggled with sensory and schedule unpredictability triggers. Once her anxiety was supported with neurofeedback and routine sensory breaks, her behavior shifted—revealing how anxiety and ADHD-like traits can co-exist.
What Is the 3‑3‑3 Rule for Anxious Children?
When your child is caught in a worry spiral or feeling overwhelmed, the 3‑3‑3 Rule offers a quick grounding tool to help calm the brain and bring them back to the present moment by engaging their senses. You can share it as a playful exercise—behavior is communication, and this tool lets their body speak safely.
How it works (simple and kid‑friendly):
- Name 3 things you can see (e.g., “That blue chair, a green leaf, your yellow sock”).
- Name 3 things you can hear (e.g., birds chirping, a clock ticking, distant chatter).
- Move 3 parts of your body (e.g., wiggle fingers, shrug shoulders, stomp your feet)
| Step | What to Do | What to Do |
|---|---|---|
| See | Child names three visible objects, focusing on details | Redirects attention to the environment |
| Hear | Child listens and lists three distinct sounds | Grounds them in the present through non‑emotional input |
| Move | Child engages three body parts (wiggle, tap, stretch) | Releases tension and reconnects them physically |
You can repeat the sequence as needed. Over time, it becomes a go‑to tool—even at school or out with friends.
What steps can parents take right away?
Let’s calm the brain first: here are steps to help you and your child:
- Model calm behavior: breathe deeply, talk softly, validate feelings (“I see you’re upset—let’s slow things down”).
- Set predictable routines: consistent wake, rest, meal, and homework times reduce uncertainty.
- Use co‑regulation tools: storybooks about feelings, rhythmic breathing, grounding activities.
- Validate emotion first: “You’re not alone.” Let your child know their emotions make sense.
- Create exposure gently: don’t avoid triggers altogether—address them in small, supported steps.
- Consider using a screening tool: SCARED, Spence Children’s Anxiety Scale, or a BrainBehaviorReset neurofeedback intake can clarify needs.
- Seek support early: on average, it takes 11 years for kids with mental health needs to get help. Don’t wait. Seek Therapy.
Parent Action Steps
FAQs
Can child anxiety mimic ADHD?
Yes. Anxiety can manifest as restlessness, inattention, or defiance—but the root may be a dysregulated brain locked in fight‑or‑flight.
Are anxious kids just sensitive?
Sensitivity is part of it—especially in gifted or creative children—but anxiety involves persistent worry, avoidance, physical symptoms, and intensity beyond typical sensitivity.
How do I know when my child needs professional help?
Consider consulting a professional if anxiety interferes with school, sleep, friendships, or daily life—even if grades are good.
Citations
- Zeman, J., Cassano, M., Perry‐Parrish, C., & Stegall, S. (2006). Emotion regulation in children and adolescents. Journal of Developmental and Behavioral Pediatrics, 27(2), 155–168. https://doi.org/10.1097/00004703-200604000-00014
- Paulus, F. W., Ohmann, S., Möhler, E., Plener, P., & Popow, C. (2021). Emotional dysregulation in children and adolescents with psychiatric disorders: A narrative review. Frontiers in Psychiatry, 12, 628252. https://doi.org/10.3389/fpsyt.2021.628252
- McLaughlin, K. A., et al. (2012). Gender differences in emotion dysregulation and anxiety in youth. Personality and Individual Differences, 53(3), 284–288.
Dr. Roseann Capanna-Hodge is a licensed mental health expert that is frequently cited in the media:
- Medium: Elemental The Covid-19 Symptoms No One Talks About: Survivors carry guilt, anxiety, and shame.
- Parade Want to Know How to Overcome Social Anxiety? We’ve got Help!.
- PIX 11 (Video) Election Anxiety
Disclaimer: This article is not intended to give health advice and it is recommended to consult with a physician before beginning any new wellness regime. *The effectiveness of diagnosis and treatment vary by patient and condition. Dr. Roseann Capanna-Hodge, LLC does not guarantee certain results.
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