Anxiety is more than feeling stressed or worried
Whether a diagnosis is made (by a health professional) will depend on how often, how easily and how intensely a child or young person experiences the symptoms of anxiety and how much it interferes with everyday living.
Common signs and symptoms of anxiety include:
- feeling more anxious than others their age and level
- having anxious feelings are consistently very intense
- feelings that persist well after the stressful event has passed
- feeling so distressed that it interferes with their capacity to learn, socialise and do everyday things.
It’s estimated that one in 14 children and young people experience anxiety.
There are a range of effective treatments and supports available, focusing on how to enable them to manage their condition.
How do anxiety conditions develop?
An anxiety condition isn't caused by a single factor but a combination of things.
Various factors play a role, including:
- family history of mental health conditions
- personality factors
- a learnt response
- physical health problems
- other mental health conditions
- substance use
- ongoing stressful events.
Possible triggers for ongoing stressful events include transitions (such as starting at a school), change in living arrangements, family relationship problems, major emotional shock following a stressful or traumatic event, being the recipient of bullying, verbal, sexual, physical or emotional abuse or trauma, and death or loss of a loved one.
What signs should I look out for?
Feeling anxious is a survival response to situations where there are dangers or threats: it helps us to respond efficiently.
However, some people react more quickly or more intensely to such situations.
Age is important
There are similarities but also key differences in the way anxiety may manifest throughout development from early childhood to adolescence.For example, if a baby cries when an unfamiliar person wants to hold them, their fear seems perfectly normal for this age. But if a 12-year-old withdraws or refuses to talk to new people and avoids situation where it may be expected, this may be evidence of a more serious anxiety issue. No matter the age, both children and young people can have difficulty finding the words to express what they are feeling – their behaviour may be the best clue.
Young children are in the early stages of learning how to recognise, understand and respond appropriately to their emotions. Anxiety disorders are less likely to be formally identified in children under five partly because certain fears are considered normal – for instance, fear of the dark, visiting unfamiliar places or separating from a family member.
Behaviours that might indicate they’re experiencing higher levels of anxiety than average could include:
- taking a long time to calm or settle following separation from a family member on a regular basis
- frequent tantrums that are more regular or severe than others of the same age
- low interest or significant reluctance to interact in social situations
- unwillingness to get involved in unfamiliar activities
- significant difficulty or distress during change or transitions
- clingy behaviour or inability to separate from a favourite educator.
Many children in early childhood will display one or more of the above behaviours; however, if it happens on a regular basis and interferes with the child’s ability to learn and engage in social relationships, then it’s a sign they need additional support.
Primary school years
As children’s thinking skills expand and become more abstract, they can develop fears of imaginary creatures and monsters. They may also worry about schoolwork, tests and their social relationships. As they grow older, they may have anxiety about family relationships or global issues such as war or famine.
The following behaviours might indicate a primary school-age child is experiencing higher levels of anxiety than average:
- Wanting things to be perfect.
- Reluctance to ask for help.
- Asking for reassurance excessively.
- Difficulty joining in.
- Requests to go to sick bay.
- Challenging behaviour.
During adolescence, common sources of anxiety include starting secondary school, fitting in with peers, exam stress, body image and family relationships. Worrying about these things isn’t necessarily a sign of a mental health condition. But individuals may need additional support if they experience the following:
- Appearing withdrawn and reluctant to participate in classroom activities or social situations.
- Oversensitivity to criticism or feedback.
- Perfectionist and fear of failure.
- Missing classes or excusing themselves to go to the toilet on a regular basis.
- Negative thinking and always expecting the worst.
- Challenging behaviour.
Looking beyond behaviour to try to identify what might be underneath can help you respond with understanding. Anxiety can be difficult to spot because it presents in many ways. The important point is to notice that there’s a concern and seek further advice and assistance.
Find out more about how you can support children and young people with anxiety.
Egger, H.L., & Angold, A. (2006). Common emotional and behavioral disorders in preschool children: Presentation, nosology, and epidemiology. Journal of Child Psychology and Psychiatry, 47, 331–337.
James, A.C., James, G., Cowdrey, F.A., Soler, A., & Choke, A. (2013). Cognitive behavioural therapy for anxiety disorders in children and adolescents. Cochrane Database of Systematic Reviews 2013, 6, CD004690.
Lawrence, D., Johnson, S., Hafekost, J., Boterhoven De Haan, K., Sawyer, M., Ainley, J., Zubrick, S.R. (2015). The Mental Health of Children and Adolescents. Report on the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Department of Health, Canberra.
Paulus, F.W., Backes, A., Sander, C.S., Weber, M., & Gontard, A. (2015). Anxiety disorders and behavioral inhibition in preschool children: A population-based study. Child Psychiatry and Human Development, 46, 150–157.
Polanczyk, G.V., Salum, G.A., Sugaya, L.S., Caye, A., & Rohde, L.A. (2015). Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. Journal of Child Psychology And Psychiatry, 56, 345–365.
External linksBeyond Blue – Anxietyheadspace – What is anxiety & the effects on mental healthRaising Children Network – Anxiety in childrenReachOut – What is anxiety?