I’ve been wanting to write about anxiety since COVID-19 lockdowns began in March, and although several months have passed, anxiety remains a major issue for children. Children (and adults) of all ages are anxious about all the upheaval in the world – from COVID to conversations on racism – and these fears aren’t the kind that can be alleviated by sleeping with the lights on. Upsetting or scary events can trigger anxiety in children.
Children will have different levels of worry depending on their level of awareness, and unfortunately, parents are limited in the reassurance they can provide. Adults are worried too, which can make it difficult to identify and manage their child’s anxiety.
Children are very aware that their routines are disrupted. They see people wearing face masks in public. They know they haven’t visited with people they usually see regularly. Children pick up on images and keywords that they see and hear in the media and in our conversations—the ones we don’t think they are listening to. Young children especially pick up on the feelings of their parents.
Our bodies are wired to keep us safe. When our children sense danger, it is nearly impossible for them to function normally. This means they can’t learn (so forget about ‘school at home’), and they may revert to behavior they had used when they were younger.
Young children are not usually able to clearly articulate their feelings, so parents are left with many questions. How do we know if our children are anxious? How much anxiety is normal? What should we do about our child’s anxiety? Am I doing something unintentionally to make their anxiety worse?
There are clinical signs of child anxiety, and they sometimes differ from symptoms of anxiety in adults. It’s important to note that most children will experience some kind of anxiety at some point in their lives. Right now, while we’re mostly home together for long stretches, is a good time to teach our children coping strategies that they will be able to draw on for the rest of their lives.
Two reasons to understand more about anxiety
There are two main reasons to learn more about your child’s potential anxiety. Firstly, understanding the cause of your child’s behavior may help you to give them some grace. As I put this list together, I realized that some of the struggles I’ve been having with my daughter recently may be related to anxiety. Understanding the cause of the behavior helps me to empathize with her, which in turn helps her to feel heard – and even if nothing else about the situation changes, simply feeling heard can be enormously helpful in managing anxiety. It also helps me to make a plan to provide help for her. Children rarely come to their parents and explain their worries. Rather, their anxiety comes out in ways that may look like “behavior problems” that need to be “fixed.”
Secondly, once we’re more aware about our children’s experiences we can choose strategies for helping children cope with their anxiety that are more likely to be useful. Often child anxiety is viewed as a behavioral problem to be solved, and interventions are often a version of reinforcing “good” behavior and ignoring “bad” behavior. The problem with this approach is that it never deals with the root cause of the anxiety so while the behavior may change, the actual underlying feeling probably has not.
I’m not going to give you a silver bullet to make family life blissful (although if there was one, I’d let you know!). I hope implementing some of these strategies will help you to support your child, which may in turn make life easier for you. In some cases, professional intervention may be necessary. This article cannot be viewed as medical advice. Throughout this post, I hope to show you how to identify anxiety and decide when the time is right to seek professional help.
12 signs that your child may be experiencing anxiety
Emotional symptoms of anxiety are very common. Children may be excessively worried about themselves, friends, or family. They may worry about events before they happen, and they may worry about events that could happen.
It’s hard to remember that irritability is a symptom of anxiety. This is a symptom that can sneak up on us. More frequent tantrums, outbursts, and whining could all be described as an increase in irritability – and even though these behaviors are also irritating to us parents, just trying to get the child to change their behavior doesn’t actually address the root of the problem.
When the lockdown started and my daughter followed me all over the house and wanted to be on my lap all the time, I thought she was missing her friends and teachers. As time has gone on, I’ve noticed that she isn’t talking as much about her friends and teachers, but she still wants to hang on me which gets pretty frustrating. It wasn’t until I started researching for this post that it dawned on me—this clinginess isn’t just missing people – it could be an indication of anxiety. Her recent clinginess isn’t a surprise when I consider how different and confusing life has become for her.
After the World Trade Center Attack, researchers studying public school students in New York City determined that rates of Separation Anxiety Disorder (SAD) increased. They concluded, “SAD should be considered among the conditions likely to be found in children after a large-scale disaster.”
4. Regression in development
Regression is so tough for parents to deal with. After working for months to get your child to sleep through the night in their own bed or use the toilet consistently, suddenly the problems are back! It’s very tough to maintain your composure. (Remember to be mindful!) When children are confronted with something new or stressful, regression is a very typical reaction. Expressing empathy for your child – who also worked very hard to move past this behavior – is helpful in this instance. Let your child know that when things change, it’s normal for kids to ‘forget’ things they’ve already learned. Be sure not to shame your child and try to keep calm. Handle the set-back and move on.
5. Withdrawing from family
Right now most of us are feeling withdrawn from our social connections, but some children who are experiencing anxiety may take withdrawing to a new level. Even shy children typically engage with close friends and family. If your child seems to be engaging less frequently with familiar people or avoiding family activities, that’s something to worth noting. While withdrawal on its own doesn’t indicate that a child is anxious, there’s research that indicates withdrawal has a connection to anxiety and other mental health concerns. We also know that social connection is one of the key resilience-building strategies, so withdrawal from social connections could have negative consequences later on.
6. ‘Disrespectful’ behavior
When I use the word ‘disrespectful,’ I’m thinking of a few behaviors. Primarily, I’m thinking of ‘not listening.’ When children ‘aren’t listening,’ there could be several things going on. Children are distracted or unfocused, so they hear your direction and plan to follow it, but something distracts them from following through. Other behaviors that may seem ‘disrespectful’ are attention-seeking or impulsive. (And, of course, I put these terms in quotation marks to indicate that disrespectful behavior is really in the eye of the beholder. Your child doesn’t mean to deliberately disrespect you; they are just doing the best they can to meet their own need and this happens to be in a way that seems disrespectful to you.)
When children lose interest in activities or foods they usually really enjoy, it’s a sign that something might be wrong. It isn’t necessarily anxiety, but it could be. It’s worth exploring. This is a tough problem because if you ask the child to explain their change in attitude, you’re likely to just get a shoulder shrug in response.
8. Problems sleeping
Difficulty falling asleep or staying asleep, possibly due to nightmares, is a significant red-flag for anxiety. Difficult sleep can also compound the effects of anxiety because we don’t function as well without proper sleep. If your child is having trouble sleeping, chances are high that they are or will start to display other symptoms simply because there is so much overlap. Being stuck at home, combined with long summer days (for those of us in the Northern Hemisphere) has made it hard for many of us to maintain a consistent bedtime and sleep schedule. The difficulty sleeping could be caused by factors other than anxiety. Exposure to blue light (screens) before bed, , and bedtime routine inconsistency can all cause sleep disruptions.
9. Change in appetite
A change in appetite might be hard to identify since children are always growing and the things they like can change from one week to the next. Appetite can fluctuate under normal conditions. A change that is significant enough to make them lose weight, especially if they are very young, will require intervention. Get in touch with your pediatrician if your child is losing weight. Most pediatrician offices that I’m familiar with are happy to check height and weight at no charge.
10. Physical changes or problems
Physical problems won’t always be present, but look out for several potential issues. The symptoms we commonly associate with panic attacks can occur in children with anxiety: shortness of breath, rapid heart rate, shaking, dizziness, and sweating. Headaches and stomachaches are some of the most common physical symptoms children display. They might also just seem tired or worn out most of the time.
I put restlessness and inattention together because they have a lot in common. Anxiety makes it hard for children to stick with anything—mentally or physically. They have intrusive thoughts about whatever they are scared about. Both inattention and restlessness are also symptoms of ADHD, so anxiety can easily be mistaken for and misdiagnosed as ADHD.
Perfectionism frequently occurs in children with anxiety. If your child is intent on everything being perfect, they may also have anxiety. Perfectionism isn’t considered a diagnostic symptom, so a physician wouldn’t diagnose anxiety because a child is a perfectionist, but there is a significant correlation between the two. (I’ll have a podcast episode on this topic out soon!)
If you’re seeing some of these symptoms and you’re considering reaching out to a professional, you might consider keeping a symptom journal first. There are phone apps that make it easy to do this, or you can track in a journal. When tracking, make note of the date and time you notice behaviors. You will want to track incidents like crying spells or angry outbursts as well as daily trends—lethargic all day, whiny all day, bouncing off the walls all afternoon.
Keeping this journal is important because anxiety can look like other things. We’re all aware that sleepy or hungry children will inevitably try our patience. Anxiety can look a lot like sleep deprivation and hunger. To compound the confusion, anxiety can also cause sleep deprivation and hunger. ADHD and anxiety are hard to distinguish. There’s also evidence of a high comorbidity rate between ADHD and anxiety.
Within a week or two you will have enough data to identify trends which will help your child’s pediatrician to direct you to appropriate resources if necessary.
Addressing your child’s anxiety
There are some basic steps you can take to help with your child’s anxiety.
When I look at the list of behaviors above that can result from anxiety, I can see how a misunderstanding about the behaviors could lead well-intentioned adults to react in a way that is not helpful. For example, if a child is crying “for no reason” an adult might interpret the crying as attention-seeking behavior that they do not want to encourage. This might lead an adult to ignore the behavior or walk away from the child.
If instead we view the crying “for no reason” as actually being caused by the child’s anxiety, we understand that the child is not just trying to get something from us, they are struggling to meet their needs. They crying is an indicator of a need that isn’t being met. The child might not be conscious of the need. Seeing that life is disrupted can make our children subconsciously perceive danger, so the child’s need for safety and security isn’t being met, but they are unable to articulate this problem. If we view “back-talk,” crying, angry outbursts, and other symptoms of anxiety as cries for help, we will naturally respond very differently than if we view them as deliberate behavioral choices that we need to discourage. When we perceive the deeper cause of the behavior – the anxiety – and focus on addressing the cause rather than the surface behavior (like the crying), we realize the need for empathy in our response.
When we react to anxiety-driven behaviors empathetically, we help our child to develop self-regulation. Instead of quickly telling them not to worry because everything is ok, we help them recognize and understand their emotions. To help our children develop self-regulation, we need to engage with them. For more about this approach, I’d encourage you to listen to my podcast episode How to help a child overcome anxiety where I interview Dr. Mona Delahooke, author of Beyond Behaviors.
Routine and consistency are some of the most powerful tools we have to mitigate anxiety. With all of us at home, it’s very easy to lose the sense of structure we have in our lives. Trying to find a basic rhythm or routine to your day can really help your child’s anxiety. To keep some structure to our days, I pick certain ‘anchor points’ throughout the day and try to make sure these things happen at set times. My daughter likes to eat her breakfast in front of Octonauts each day, something I wouldn’t have permitted in pre-COVID times but she enjoys the routine. Then screen time for the day is mostly done, and she plays outside. We eat lunch around noon and dinner at 6:45, and every day we have an hour of dedicated 1:1 time together. Other tasks may shift around during the day, but having these anchor points helps her to know what’s coming.
When children express anxiety, it is important to react with kindness and not to shame them. This doesn’t mean that we have to restrict our lives to avoid making them afraid. If a child is afraid to leave the house, we can require them to leave the house without shaming them. Empathy is crucial. We can take action to mitigate their fears—like allowing them to bring a special comfort object—without allowing them to dictate how the family lives. Listen to their fears. Teach them how to take deep breaths. Explain what is going to happen in terms they will understand, and give them choices when it’s possible. Never tease your child about their fear.
We can address our child’s fears by teaching them to be prepared. Some children will feel better understanding the safest way to respond to a crisis they are imagining. Doing a fire drill or acting out a scenario where they have to find help can be very powerful. Uncertainty is very frightening. Walking through what would happen in an emergency is reassuring for children. For example, if they are scared of you dying, you can tell them that while you have no intention of dying, they will be ok even if it happened. When my daughter asked me what would happen if her dad and I died, I told her who she would go live with. Knowing what would happen in a worst-case scenario did seem to give her some comfort.
My favorite tool to combat anxiety is play. During play, our brains are thinking, planning, and organizing information. The state of mind we use when we play pushes out the anxious state of mind. Remember that play is a broad term. You don’t have to play pretend or search Pinterest for “play ideas.” You can clean up toys or eat a snack in a playful way. My daughter and I have had hours of play rolling a bouncy ball around our living room. There’s no need to make an enormous mess or an elaborate plan.
We can also fight anxiousness with music and movement. Dancing to music you enjoy is a powerful experience. By moving our focus from our head to our body, we give our mind a break from worry. Movement or exercise is well-established as a strategy for maintaining mental health. Since you’re likely spending more time than usual at home, your life may have become more sedentary. Dancing is a fun way to bring some activity to your days and reduce anxiety for the entire family.
Do I need to seek professional help for my child’s anxiety?
To be clear, this article does not substitute for professional help. I’ve provided a few strategies that may help you manage mild symptoms of anxiety, but no one can provide sound advice regarding your child’s mental health without direct consultation.
When I spoke to a developmental psychologist, my major takeaway was this:
If there’s no impairment or impact on the child’s life, then you don’t need to worry. Professionals look for impairment. If the child’s life is impaired, it is time to intervene. If your child’s symptoms are interfering with daily life, I encourage you to reach out to your pediatrician or a child therapist. For example, if your child isn’t getting the sleep they need or eating the number of calories they need, that can have serious health consequences, so the problems need to be addressed. If your child is too scared or worried to enjoy a trip to the park or family game night, then the anxiety is getting in the way of their daily life.
I hope this information helps you to better support your children through this difficult time.