Understanding Childhood Anxiety - SACAP
Applied Psychology

Understanding Childhood Anxiety

May 28, 2024 | By Bev Moss-Reilly and Dr Diana De Sousa
little girl sitting on couch in silence as a result of childhood anxiety

Learn about childhood anxiety, its causes, signs, and what parents can do to help their anxious children cope, especially in today’s stressful times. By grasping the nature of child anxiety and learning how to assist a child is key to offering them support and assistance. 

Decoding Childhood Anxiety: A Comprehensive Guide

Children often develop fears, real or imagined. Parents can help by taking fears seriously, providing truthful information, encouraging gradual exposure, and maintaining routines.  

Why is Your Child Anxious?

Normal Childhood Anxiety

Anxiety and fear are normal parts of childhood. Fear is a natural reaction to danger or threat, while anxiety arises in response to a possible threat. New fears and anxiety are usually short-lived and indicate that children are learning to solve problems independently.  

However, up to 1 in 5 children may develop anxiety disorders, which differ from normal fear or anxiety. These disorders involve more extreme avoidance, intense emotional reactions, or longer-lasting symptoms. Anxiety disorders go beyond normal fear of anxiety. They involve:   

  • Extreme avoidance behaviours.  
  • Intense emotional reactions.  
  • Longer-lasting symptoms.  

Anxiety in children is a common experience, and it’s essential to understand its causes and manifestations.  

Factors that contribute to childhood anxiety:  

  • Genetic Predispositions: Some children inherit a vulnerability to anxiety. Family history plays a role in determining whether a child is more prone to anxiety.
  • Brain Chemistry: Neurotransmitters and brain circuits influence anxiety.  Imbalances can contribute to anxiety disorders. Imbalances in these systems can contribute to anxiety disorders. These imbalances may affect how a child perceives and responds to stressors.  
  • Life Experiences: Traumatic events (e.g., loss, abuse, accidents) can trigger anxiety.  
  • Stressful life transitions (e.g., starting school, moving) impact children. These transitions impact their emotional wellbeing and may trigger anxiety.  
  • Environmental Stressors:
    • School-related Anxiety: Fear of academic performance, social interactions, or fitting in at school can trigger anxiety. Children may worry about meeting expectations or facing challenges in the classroom.  
    • Social Pressures: Making friends, peer acceptance, and navigating social expectations. Social situations can be overwhelming, especially if a child fears judgment or rejection.  
    • Parental Anxiety: Children absorb parental stress and anxiety. If parents experience high levels of anxiety, it can affect their children’s emotional state and may trigger anxiety.  
    • Family Dynamics: Conflict, instability, or overprotectiveness affect a child’s emotional wellbeing can contribute to children experiencing anxiety. 

Recognizing Signs of Anxiety in Children

Anxiety can significantly impact a child’s wellbeing, and early intervention is crucial. As caregivers, it’s essential to recognize signs of anxiety and create an environment where children feel comfortable expressing their feelings. Remember that each child is unique, and symptoms may vary.  

Here are common types of childhood anxiety and their associated signs:

Separation Anxiety Disorder


  • Fear of parental illness or loss.  
  • Reluctance to leave home or attend school.  
  • Dread of solitude or sleeping alone.  
  • Nightmares related to separation.  

Physical symptoms: Headaches or stomach aches before anticipated separations are most common.  

Duration: Symptoms persist for at least four weeks.  

Social Anxiety Disorder


  • Avoidance or distress in social settings.  
  • Physiological reactions (trembling, sweating, breathing difficulties) during social interactions.  
  • Tantrums or tears in social situations (especially among young children).  
  • Apprehension about others perceiving their anxiety.  

Severity: Impedes daily functioning significantly.  

Selective Mutism


  • Difficulty communicating verbally in specific contexts (often in educational environments).  
  • Variable ability to speak.  
  • Duration of the issue extends for at least a month.  
  • Impairment in educational and social spheres due to communication challenges.  

Generalised Anxiety Disorder


  • Restlessness.  
  • Persistent edginess.  
  • Chronic fatigue.  
  • Impaired concentration.  
  • Heightened irritability.  
  • Sleep disturbances.  

Duration: Symptoms occur on most days for at least six months. 

 Panic Disorder


  • Recurrent, unforeseen panic attacks with overwhelming physical sensations.  
  • Persistent fear of subsequent panic attacks.  
  • Behavioral changes (avoidance of triggering environments) post-attack.  

Diagnosis: Ruling out medical causes and other conditions like PTSD is advised.  

Obsessive-Compulsive Disorder (OCD)


  • Intrusive thoughts leading to anxiety.  
  • Compulsions (self-imposed rules) aimed at reducing distress. 

Note: The above signs exclude cases arising from communication disorders or language barriers.  

It is important to remember that open communication with children about their feelings is essential. If you notice persistent signs of anxiety, consider seeking professional help to support your child’s emotional wellbeing. 

How to Help with Childhood Anxiety

When a child experiences anxiety, it is important for parents and caregivers to respond with empathy and understanding. Even if their worries seem irrational, acknowledging their feelings as genuine is crucial. Instead of dismissing their concerns, engage in open communication to explore their thoughts and the root cause of their distress. This helps them to express their emotions in a supportive environment.

Practical Tips for Supporting Anxious Children

Open Communication

  • Encourage your child to talk about their feelings without judgment.  
  • Create a safe space where they feel comfortable sharing their worries.  
  • Listen actively and validate their emotions.  

Provide Reassurance

  • Remind your child that it’s normal to feel anxious sometimes.  
  • Offer comfort and let them know you’re there to support them.  
  • Reassure them that their feelings are valid and manageable.  

Teach Coping Strategies. Help your child learn practical techniques to manage anxiety:  

  • Deep breathing exercises.  
  • Visualization (imagining a calm place).  
  • Progressive muscle relaxation.  
  • Mindfulness techniques.  

Maintain a Structured Routine

  • Predictability and consistency can reduce anxiety.  
  • Maintain regular mealtimes, bedtime routines, and daily activities. 
  • Avoid sudden changes whenever possible.  

Promote Relaxation Techniques. Encourage activities that promote relaxation:  

  • Yoga or stretching.  
  • Listening to calming music.  
  • Spending time in nature.  
  • Engaging in hobbies they enjoy.  

Foster a Supportive Environment

  • Create a home environment where your child feels safe and loved.  
  • Encourage positive interactions with family members.  
  • Model healthy coping strategies yourself. 

When and How to Seek Help for Your Child

If your child is experiencing anxiety that significantly affects their daily life or persists over time, seeking professional help is crucial. 

Pay attention to behaviour changes in your child. Signs of anxiety may include:

  • Excessive worry 
  • Restlessness 
  • Irritability 
  • Difficulty concentrating 

Call to action

Consult with a Paediatrician: Start by discussing your child’s concern. Your child’s overall health will be assessed and if necessary, you will be referred to a mental health professional. 

Mental Health Professionals: Consider consulting with an educational psychologist or psychiatrist. Your child’s condition will be evaluated, and appropriate intervention will be recommended, be it psychotherapy or counselling. 

Therapy: Counselling and psychotherapy are the first line of treatment for childhood anxiety. Cognitive Behavioural Therapy (CBT) is particularly effective in helping children identify and change negative thought patterns and behaviours. 

Parental and Caregiver Support: As a parent, you play a crucial role. Learn about anxiety disorders, practice patience, and provide emotional support. Encourage open communication with your child. 

Medication: In some cases, medication may be prescribed. Antidepressants or anti-anxiety medications can help manage symptoms. Consult a psychiatrist to discuss the risks and benefits. 

School Involvement: Collaborate with your child’s school. Teachers can implement strategies to support your child’s emotional wellbeing in the classroom. 

Early Intervention: Address your child’s anxiety early. The sooner your child receives help, the better the outcome. 

Always remember that seeking help is a sign of strength. You are not alone in supporting your child’s wellbeing.

Are you Interested in Becoming a Psychologist?

Are you passionate about supporting children in overcoming anxiety? SACAP (The South African College of Applied Psychology) offers qualifications designed to prepare you for a career in Psychology.  

Apply today to start your journey toward fostering emotional wellbeing and resilience. 

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