Anxiety in Children: Complete Parent's Guide to Signs, Causes, and Treatment
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: September 2026
TL;DR
Anxiety in children becomes a disorder when worries or fears interfere with daily life for more than six months. Up to 1 in 5 kids will develop an anxiety disorder, and nearly 1 in 3 adolescents ages 13–18 are affected. The two main treatments — cognitive behavioral therapy (CBT) and medication — each work on their own but work better together, and many children feel more confident within just a few therapy sessions.
Quick Answer
Anxiety becomes a disorder in children when worry or fear causes distress and interferes with life for more than six months.
Anxiety disorders affect about 15%–20% of children and adolescents, and nearly 1 in 3 adolescents ages 13–18 has anxiety; they are more common in females.
Childhood anxiety often shows up as physical signs — stomachaches, headaches, trouble sleeping, restlessness, anger, and school refusal — not just words.
CBT and medication (SSRIs such as fluoxetine or sertraline, and SNRIs such as duloxetine) are the two main treatments, and they appear to work better together than alone.
What Is Anxiety in Children?
Anxiety and fear are a normal part of childhood. Fear is a natural reaction to a danger or threat. Anxiety is a reaction to a possible threat. New fears and anxiety are usually short-lived, and they show that kids are learning to solve problems on their own.
Parents and caregivers can help children learn to understand and overcome their fears and anxieties. The challenge is knowing when worry crosses the line from a normal developmental phase into something that needs professional help.
How Do You Know If a Child's Anxiety Is a Disorder?
Childhood anxiety disorders differ from normal fear or anxiety in three measurable ways. The avoidance is more extreme. The emotional reactions are bigger. And the anxiety lasts longer than expected.
The clinical threshold used by healthcare providers is duration and impairment. Anxiety is considered a disorder if worries or fears cause distress and interfere with the child's life for more than six months.
Feature | Normal childhood fear and anxiety | Childhood anxiety disorder |
Trigger | Real danger or a possible threat | Possible threats, often disproportionate |
Duration | Short-lived | Lasts longer than six months |
Intensity | Manageable | Bigger emotional reactions, crying, tantrums |
Avoidance | Occasional | Extreme: escaping, hiding, constantly on lookout for danger |
Body symptoms | Occasional | Frequent stomachaches, headaches, nausea, sleep issues |
Children with anxiety disorders often have emotional outbursts like crying or tantrums. They may show a lot of avoidance — trying to escape, hide, and stay "on the lookout for danger" much of the time. Body symptoms are also common, including stomachaches, headaches, nausea, vomiting, shortness of breath, and sleep issues.
How Common Is Childhood Anxiety?
Anxiety disorders are fairly common in children. They affect about 15% to 20% of children and adolescents. Nearly 1 in 3 adolescents between ages 13 and 18 has anxiety. It is also more common in females.
Statistic | Figure |
Kids who develop an anxiety disorder | Up to 1 in 5 |
Children and adolescents with anxiety disorders | About 15%–20% |
Adolescents ages 13–18 with anxiety | Nearly 1 in 3 |
More common in | Females |
What Are the Types of Anxiety in Children?
There are five recognized types of anxiety in children. Each looks different and needs different support strategies.
Type | What it looks like in a child |
Separation anxiety disorder | Extreme distress when apart from parents, beyond the typical developmental phase that begins at 8–12 months and usually improves by preschool |
Specific phobias | Extreme fears out of proportion to the actual threat (storms, clowns, and many other specific things) |
Social anxiety disorder | Intense fear of being judged or rejected; avoiding public speaking, performing, or interacting at school |
Generalized anxiety disorder | Excessive worry about many daily things; worries change over time but the child is always worried about something |
Panic disorder | Sudden panic attacks with racing heart, dizziness, and feeling unable to breathe; attacks come without warning and end within minutes to hours |
Separation anxiety disorder. Separation anxiety is a normal and important phase of early development that begins in most children at 8 to 12 months old. With normal separation anxiety, a child may fear strangers and not feel safe when parents are not around. It usually gets better by the time kids enter preschool. The disorder is more extreme and continues beyond this typical period. Kids may worry about parents or other family members, have difficulty going to school or being away from home, or struggle separating for sleep.
Specific phobias. Fear protects us from danger, so a certain amount of fear in kids is expected. Specific phobias are extreme fears that are out of proportion to the actual threat of danger — a child terrified of storms or clowns to the point of major disruption is different from a child who is simply cautious.
Social anxiety disorder. This is an intense fear of being judged or rejected in social situations. A child might avoid public speaking or performing. They might be so uncomfortable that they avoid interacting with others at school or have a hard time speaking to new people. They may avoid social situations altogether.
Generalized anxiety disorder. Generalized anxiety is excessive worry and fear about a range of different things that happen in daily life. The child may worry about the future more than other children their age. They may have many worries, or the worries may change over time, but they are often worried about something.
Panic disorder. Children with panic disorder have times of extreme fear and anxiety along with physical symptoms like a racing heart, dizziness, or feeling like they cannot breathe. These panic attacks can come on without warning and tend to go away within minutes to hours.
What Are the Signs and Symptoms of Childhood Anxiety?
Parenting can feel like a guessing game. Some children will use words to tell you about their anxiety. They might say something like, "I'm afraid to go to school because I'm worried I'll never see you again." Others might not know how to explain their feelings. But children also show signs of anxiety through behavior and their bodies.
Sign or symptom | How it appears |
Excessive worry | Worrying and/or crying more than other kids their age |
Physical complaints | Saying they don't feel well — upset stomach, sore muscles, or headache |
Sleep problems | Trouble sleeping, nightmares, or inability to sleep alone |
Restlessness | Hard time relaxing or sitting still |
Irritability | Angering easily |
Concentration trouble | Hard time focusing |
Appetite changes | Not hungry, or hungry all the time |
Tremors | Shaking |
School refusal | Refusing to go to school |
Frequent urination | Using the bathroom a lot |
Because many of these signs look like ordinary childhood phases, the pattern matters more than any single symptom. Anxiety becomes concerning when several signs appear together, persist, and interfere with daily life.
What Causes Anxiety in Children?
Some kids are naturally sensitive and may have a hard time coping with change or strong emotions. These children may have a biological or family tendency to be anxious. Anxiousness can also develop after stressful life events, and some people experience many stressful events from a very early age.
Stressful life events linked to childhood anxiety | Examples |
Loss | The death of someone close |
Instability in living situation | Moving to a new house or school, especially frequent moves |
Basic needs stress | Difficulty getting enough to eat or difficulty with safe places to live |
Educational disruption | Difficulty with consistent schooling |
Family conflict | Parents who fight or argue, or separation and divorce |
Harm from others | Bullying, abuse, or neglect |
What is the main cause of anxiety in children? It is hard to say for sure what the main cause of childhood anxiety is. Fear is a natural part of growing up, and some kids manage it well. For children with anxiety that interferes with day-to-day life, genetics, biology, and family history are thought to play roles.
What Are the Complications of Untreated Childhood Anxiety?
Children with anxiety are at increased risk for depression and substance use disorders later in life. They may struggle in school or with attending school. They are also at higher risk for suicide.
Although these are scary outcomes, treatments are available. Follow up with your child's healthcare provider as often as they recommend. Seek immediate medical attention or call the Suicide and Crisis Lifeline at 988 (in the United States) if you think your child might hurt themselves.
How Is Childhood Anxiety Diagnosed?
To diagnose anxiety in your child, their healthcare provider will talk with both you and your child. They will ask you about your child's behavior and how you can tell they are anxious. They will ask your child to describe any symptoms they notice and when they notice them.
The provider may ask you to complete surveys and may also want to talk to your child's teacher or other caregivers for more information about the symptoms. They will look for other causes of the symptoms.
Diagnostic step | What happens |
Parent interview | Provider asks about the child's behavior and how the parent can tell they are anxious |
Child interview | Child describes symptoms and when they notice them |
Surveys | Parent may complete screening questionnaires |
Collateral input | Provider may speak with teachers or other caregivers |
Ruling out other causes | Other medical or situational causes of symptoms are excluded |
A child may be diagnosed with an anxiety disorder if there is no other cause for their symptoms and their anxiety causes distress and has interfered with their life for six months.
How Is Childhood Anxiety Treated?
There are two main ways to treat anxiety in children: cognitive behavioral therapy and medication therapy. Both of these treatments may work on their own, but they seem to work better together.
Cognitive behavioral therapy (CBT). CBT helps children learn coping skills that help with calming body reactions, thinking differently, and facing fears and challenges in smaller steps. Children can learn coping skills in individual therapy or group therapy. Parents can also learn these coping skills so they can support their children in practicing them.
Medications. A healthcare provider may prescribe a selective serotonin reuptake inhibitor (SSRI) such as fluoxetine (Prozac®), paroxetine (Paxil®, Pexeva®), or sertraline (Zoloft®). If these are not effective or appropriate, they may prescribe a serotonin and norepinephrine reuptake inhibitor (SNRI) such as duloxetine (Cymbalta®, Drizalma®, Irenka®).
Treatment | How it works | Format |
Cognitive behavioral therapy | Coping skills: calming body reactions, thinking differently, facing fears in smaller steps | Individual or group; parents can be co-therapists |
SSRIs | First-line medication class | Fluoxetine, paroxetine, sertraline |
SNRIs | Second option when SSRIs are not effective or appropriate | Duloxetine |
Medication side effects to watch for. Call your healthcare provider if your child develops an allergic reaction, bloody stool, a fast or irregular heartbeat, fainting, dizziness, chest pain or shortness of breath, high fever, sudden vision changes or eye pain, or thoughts of suicide or worsening mood.
Urgent side effects (call provider) | Common, usually temporary side effects |
Allergic reaction | Appetite changes |
Bloody stool | Difficulty sleeping or drowsiness |
Fast or irregular heartbeat | Dry mouth |
Fainting, dizziness, chest pain, shortness of breath | Headache |
High fever | Shaking (tremors) |
Sudden vision changes or eye pain | Upset stomach, nausea, or diarrhea |
Thoughts of suicide or worsening mood | Usually resolve after a few weeks; may return with dose changes |
How Soon Will My Child Feel Better After Treatment?
Many families begin with CBT and add additional therapies if needed. CBT — either individually with a parent as co-therapist or in groups — can be very effective at teaching step-by-step coping skills that reduce symptoms and improve coping. Because this therapy involves learning, children often learn quickly and can feel better and more confident within a few sessions.
Sometimes sessions reduce some symptoms but more help is needed for kids to conquer their anxiety. In these situations, medication is also important.
Medications like SSRIs and SNRIs take time to start working, and not every medication works the same way in every person. A provider may try one medication for a period of time — usually at least several weeks to a few months — to see if it helps. If it does not help, they may try a different medication.
What Can I Expect If My Child Has Anxiety?
If your child has an anxiety disorder, they may act out or be irritable. They may cling to you or refuse to leave the house. Although treatment for childhood anxiety can take time to work, it generally reduces symptoms. With treatment, many children with anxiety participate in activities that interest them, form friendships, finish school, and enjoy life.
There may be periods when anxiety starts to overwhelm them again. When this happens, they may need adjustments to their medications or more frequent therapy sessions until their symptoms are better managed.
What Helps Childhood Anxiety at Home?
As a parent or caregiver, you cannot always manage the stressors in your child's life. But you can help improve their mental health by ensuring they get daily exercise, a safe and supportive environment at home and school, plenty of sleep, and well-balanced meals.
You can also teach your child meditation techniques and breathing exercises to help them relax. Encourage small steps to overcome normal worries — like entering a social setting while you wait a few feet away, or turning off the lights for a few minutes and practicing relaxation. This helps kids develop confidence and coping skills.
Home support strategy | What it looks like |
Daily exercise | Regular physical activity |
Safe, supportive environment | Stability at home and school |
Plenty of sleep | Consistent sleep routine |
Well-balanced meals | Nutritious, regular meals |
Relaxation practice | Meditation and breathing exercises |
Small exposure steps | Gradual confidence-building in feared situations |
When Should I Call a Healthcare Provider?
Call your healthcare provider if your child shows signs of anxiety that do not go away, or if they stop doing things you know they can do — such as using the toilet or leaving the house.
If your child shows signs of suicide, get help right away. Call the Suicide and Crisis Lifeline at 988 (in the United States), which connects you to a national network of local crisis centers for free, confidential emotional support 24 hours a day, 7 days a week. In an emergency, call 911.
A note for parents: parenting a child with anxiety is difficult. It takes a grounded, patient caregiver to look past a child's demands and irritability to see that anxiety drives their behavior. Finding the right treatment can take time, but that is okay — do not be dissuaded. Take time for yourself, too. Just as you notice your child's anxiety, they notice and are affected by yours.
Conclusion: Early Help Changes the Trajectory
Childhood anxiety is common — up to 1 in 5 kids will develop an anxiety disorder — and it is often invisible because children express it through their bodies and behavior rather than words. The good news is that anxiety disorders are treatable. CBT and medication each work, and together they appear to work best. Many children feel noticeably more confident within a few therapy sessions, and with sustained treatment, most go on to participate in activities, form friendships, and enjoy life.
Take action today: if your child's worries have persisted for months and are interfering with school, sleep, friendships, or daily routines, schedule an evaluation with their healthcare provider. Early intervention is the single most powerful lever parents have — and support for parents matters too, because children feel and mirror the stress of the adults around them.
Frequently Asked Questions
At what point is my child's anxiety considered a disorder?
Anxiety is considered a disorder in children when worries or fears cause distress and interfere with their daily life for more than six months. Before that point, worry and fear are usually a normal part of development.
How common is anxiety in children?
Anxiety disorders affect about 15% to 20% of children and adolescents, and nearly 1 in 3 adolescents between ages 13 and 18 has anxiety. Anxiety is also more common in females.
Can a child have anxiety without saying they are anxious?
Yes. Many children do not know how to explain their feelings. They often show anxiety through physical complaints like stomachaches, headaches, or sore muscles, through sleep problems and nightmares, restlessness, anger, trouble focusing, appetite changes, tremors, school refusal, or frequent bathroom use.
What is the most common type of anxiety in children?
Five types of anxiety occur in children: separation anxiety disorder, specific phobias, social anxiety disorder, generalized anxiety disorder, and panic disorder. Separation anxiety is the type most parents encounter first, since it begins as a normal phase at 8 to 12 months of age; it becomes a disorder only when it is extreme and continues beyond the typical developmental period.
What is the main cause of anxiety in children?
There is no single main cause. For children whose anxiety interferes with daily life, genetics, biology, and family history are thought to play roles. Stressful life events — such as loss, frequent moves, family conflict, divorce, or bullying — can also trigger anxiety.
What is the best treatment for childhood anxiety?
Cognitive behavioral therapy (CBT) and medication are the two main treatments. Both can work on their own, but they seem to work better together. Providers typically start with CBT, then add medication such as an SSRI (fluoxetine, paroxetine, sertraline) or SNRI (duloxetine) if needed.
How long does it take for treatment to work?
Many children learn coping skills quickly and feel better and more confident within a few CBT sessions. Medications like SSRIs and SNRIs take longer — usually at least several weeks to a few months of a trial before judging whether they help.
Will my child outgrow their anxiety disorder?
Treatment generally reduces symptoms, and with treatment many children participate in activities, form friendships, finish school, and enjoy life. However, there may be periods when anxiety overwhelms them again, requiring medication adjustments or more frequent therapy sessions.
Related Resources
References
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions about your child's health or before starting or changing any treatment. If your child is in crisis or may harm themselves, call the Suicide and Crisis Lifeline at 988 (US) or 911 immediately.
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