Childhood Anxiety

Signs of Anxiety in Children: What It Looks Like and How to Help

When we picture an anxious child, we tend to imagine a quiet, worried little one chewing their sleeve. Sometimes that's exactly right. But in my work as a paediatric occupational therapist, anxiety just as often arrives in disguise — as anger, as defiance, as a tummy ache before school, or as a child who suddenly "won't" do something they managed easily last week. Recognising those disguises is often the first step to helping.

Anxiety doesn't always look like worry

Children rarely have the words to say "I feel anxious." Instead, their nervous system says it for them, through behaviour. Anxiety in children can look like irritability and big emotional outbursts, clinginess or reluctance to separate, avoiding certain places or activities, trouble sleeping, or a string of physical complaints — headaches and sore tummies that have no obvious medical cause.

It's easy to read these as naughtiness or stubbornness. But a child in the grip of anxiety isn't choosing to be difficult; their brain has flipped into protection mode, and the behaviour we see is the overflow. When we can look past the behaviour to the feeling underneath, our whole response softens — and that shift alone often helps a child settle.

Why it shows up in the body

Anxiety is, at its heart, the body's alarm system doing its job a little too enthusiastically. When a child feels threatened — by something as ordinary as a noisy classroom or a change in routine — the body floods with stress chemicals designed for fight or flight. The heart races, the tummy churns, muscles tense. This is why so much childhood anxiety is felt physically first. A child genuinely does have a sore tummy; it's just that the cause is worry, not a bug.

Understanding this helps us respond with compassion rather than frustration. We're not dealing with a child who is overreacting. We're dealing with a child whose body is reacting exactly as it's built to — and who needs our help to feel safe enough for the alarm to switch off.

How to respond in the moment

When your child is in the thick of an anxious moment, a few things tend to help far more than reasoning or reassurance-on-repeat:

Stay calm and steady yourself first. Children borrow our nervous systems. A slow, warm, unhurried parent is the single most calming thing in the room.

Name the feeling, gently. "Your body feels really worried right now, and that's okay" tells a child they're understood and that the feeling isn't dangerous. Naming it helps tame it.

Don't rush to fix or dismiss. Phrases like "there's nothing to worry about" rarely land — the worry is already there. Sitting *with* the feeling, rather than arguing it away, helps it pass.

Bring the body back down. Slow breathing, a tight hug, a quiet space, or a drink of water all signal safety to an over-fired alarm system. Calm the body and the thinking brain comes back online.

Building coping skills over time

Moment-to-moment support matters, but the real goal is helping children build their own toolkit so that, over time, they can manage worry themselves. That comes from gentle, repeated practice when everyone is calm — not in the heat of the moment. Simple breathing games, talking about feelings as a normal part of family life, gradually facing feared situations in small steps rather than avoiding them, and celebrating brave tries all slowly rewire a child's relationship with anxiety. Skills like these are exactly the kind of thing I work on with children in my sessions, and they genuinely do grow with practice.

When to reach out for support

Some anxiety is a normal, even healthy part of growing up. But if worry is regularly stopping your child from doing the things they want or need to do — going to school, seeing friends, sleeping, enjoying their days — or if it's escalating rather than easing, please don't wait it out alone. Speak to your GP, your child's teacher, or a paediatric occupational therapist or psychologist. Reaching out early isn't an overreaction; it's one of the kindest things you can do, and effective support is very much available.

This is a sensitive topic, and reading about it can stir things up — for our children and for us. If your own worry about your child is feeling heavy, that's worth acknowledging too, and support exists for parents just as much as for children.

Carrying the strategies home

The children I see make the most progress when the calming, confidence-building work continues gently at home, between sessions. That's why I wrote the Anxiety Workbook for Kids — to put the mindfulness and problem-solving activities I use in practice into a format families can work through together, at their own pace. If this article felt familiar, it may be a helpful place to start. You'll find it, along with my other guides for children and teens, on my Books & Resources page.

Anxiety can feel frightening to watch in a child you love. But it's also one of the most workable challenges of childhood — and with understanding, patience, and the right tools, children really can learn to feel safe in their own bodies again.