Understanding and Helping Your Anxious Child

As a parent, it can be hard to know whether your child’s behavior is just a normal childhood phase or a sign of anxiety requiring professional help. Many caring parents describe feeling confused and concerned, wanting to do what’s best for their child’s wellbeing and development.

This guide will walk you through the key signs of anxiety in children, how to differentiate normal fears versus problematic anxiety, and evidence-based treatment options to help your child overcome anxiety and thrive.

We recently did an episode on this very topic on the Life Free of Anxiety podcast. You can listen below OR find a transcript at the bottom of this blog post.

What Does Childhood Anxiety Look Like?

The way anxiety presents in children may seem different than what we expect with adults. Kids may not be able to verbalize feeling “anxious” or know how to identify the physical symptoms they’re experiencing.

Here are some common signs of anxiety in children:

• Avoiding new people/places or clingy behavior, especially at school drop-offs. While some separation anxiety is normal, excessive or ongoing distress is a red flag.
• Headaches, stomachaches, fatigue complaining of feeling sick, often without any medical cause. These can be somatic manifestations of anxiety.
• Trouble sleeping, nightmares or disrupted sleep.
• Avoiding school or activities the child used to enjoy.
• Outbursts, irritability, trouble concentrating.
• Constant worrying or crying.
• Regressing to more “babyish” behaviors in younger kids.
• Withdrawing socially or seeming constantly nervous/fearful.

If you notice one or more of these signs lasting weeks or disrupting your child’s ability to function normally, it may indicate an anxiety issue. Track when the behaviors started to identify possible triggers. Also compare your child’s behavior to same-age peers - is your child significantly more fearful or avoidant than other kids?

When to Seek Professional Help

As children grow and develop, some fears and anxious behaviors can be totally normal, especially around major life changes like starting school. The American Academy of Pediatrics notes these common childhood fears:

• Ages 3-6: imaginary creatures, the dark, specific animals, sleeping alone.
• Ages 7-12: injury, death, school performance, family conflicts.
• Teens: social evaluation, relationships, school performance.

These worries tend to be transient if kids are otherwise coping well. Anxiety becomes problematic when it:

• Persists beyond the typical duration
• Causes significant distress
• Disrupts daily functioning
• Is disproportionate to actual risk.

Seeking professional support can help identify whether anxiety is the root cause and equip your child with evidence-based tools to overcome it. Left untreated, chronic childhood anxiety often continues into adulthood. Early intervention improves long-term mental health outcomes.

The Impact of Childhood Anxiety

Living with anxiety long-term negatively affects children’s social, emotional, and cognitive development. Anxious kids may:

• Struggle academically due to trouble concentrating, retaining information, or speaking up in class.
• Have impaired executive functioning skills like planning, focus, and impulse control.
• Avoid social situations leading to isolation and stunted social growth.
• Have lower self-confidence, feeling defined by their anxiety.
• Develop additional mental health issues like depression down the road.

The good news is with professional support, children can learn to master their anxiety early on, equipping them with healthy coping skills for life. Evidence-based treatment empowers kids to reduce anxiety symptoms and build resilience.

Effective Treatments for Childhood Anxiety

Cognitive behavioral therapy (CBT) is considered the gold standard treatment for anxiety. CBT helps kids recognize anxious thoughts, understand how thoughts influence emotions/behavior, and develop constructive coping strategies.

Common CBT techniques include:

• Exposure therapy - gradually facing fears to overcome them.
• Cognitive restructuring - identifying and reframing unhelpful thought patterns.
• Relaxation strategies - deep breathing, visualization, muscle relaxation.
• Psychoeducation - learning about anxiety to normalize it.

CBT can be done individually or in a group format. Group CBT allows kids to feel less alone and practice social skills in a safe environment.

Involving parents is also key. Family therapy equips parents to reinforce skills at home and model healthy coping themselves. Programs like LifeSkills for Kids teach children cognitive-behavioral tools to manage anxiety alongside parent coaching and support.

Medication may be considered in severe cases if therapy alone is insufficient. SSRIs like Zoloft are sometimes prescribed for anxiety in children over 6 but have side effects to weigh.

No matter your child’s age, early intervention with professional cognitive-behavioral support can help prevent anxiety from limiting their potential. As Studies show CBT helps over 75% of children reduce anxiety symptoms significantly. There is hope!

When to Seek Help

Don’t wait to get assessed if your child is displaying emotional or behavioral changes lasting more than 2-4 weeks that seem disproportionate to actual threats. The earlier anxiety is addressed, the less likely it will disrupt their development.

Seek support from:

• Your pediatrician - they can refer you to a specialist like a child psychologist or psychiatrist.
• Your school counselor - they can share observations from the classroom.
• Therapists specializing in childhood anxiety - ask about experience with evidence-based approaches like CBT.
• LifeSkills for Kids - the renowned childhood anxiety program from CHAANGE, home of the CHAANGE Anxiety Treatment Program that has helped over 200,000 anxiety sufferers reclaim their lives.

Trust your gut if your child seems stuck in an anxious pattern. With professional support, children can learn healthy ways to cope with anxiety and thrive emotionally. There are so many reasons to feel hopeful!

Life Free of Anxiety PODCAST EPISODE TRANSCRIPT: Does My Child Have Anxiety? Three Symptoms to Look Out For!

[00:00:00] Erica: Welcome to the Life Free of Anxiety podcast. We have a great episode for you right now about children. How to help your children for real. Physically, mentally, we've got something for your kids now. And we're very excited. Dr. Barr has actually used this program on many, many children. And this is kind of like the partner to the CHAANGE Anxiety Treatment Program.

So if you're one of our people who did the CHAANGE Anxiety Treatment Program Program and gave us a survey at the end that you were happy at a level nine after doing it, which that really happens. I'm not making that up. We've got something for your kids now. All right, let's get to the show.

[00:00:36] INTRO MUSIC

[00:00:36] Erica: Welcome to the Life Free of Anxiety Podcast, where each week we'll bring you another discussion to help you on your way to overcoming your fears. I'm Erica and together with Dr. Charles Barr, a licensed clinical psychologist, specializing in anxiety, we'll be your guides on this journey. Because you are not broken, you are not alone.

And you are on your way to living a life free of anxiety.

[00:01:10] Main Episode

[00:01:10] Erica: Well, It's the Life Free of Anxiety podcast. I'm always happy to be here with Dr. Barr. I'm Erica.

[00:01:16] Dr. Charles Barr: I'm here too.

[00:01:17] Erica: You know, Dr. Barr, on the last episode, real quick, I did share about your 50 states quest with your wife. And I think that's pretty cool that you guys have sought out to see all 50 states that you've seen so many so far.

[00:01:30] Dr. Charles Barr: Well, she lacks four and I lack five, so she's ahead of me. She's been to Michigan and I haven't.

[00:01:37] Erica: Oh, it's always Michigan. Well, I think it's really cool that you guys like to have so much fun and you're so adventurous.

[00:01:44] Dr. Charles Barr: Well, it is fun. We've enjoyed doing it. We've been doing it our entire married life. So we didn't just start, you know, we've been taking family vacations to go different places. That's part of the difficulty with being anxious is it shrinks your world. And where you might want to go and see some things you're just too anxious to go and too afraid. And, that's really a shame. And that's part of what being free of anxiety can do for you is it can free you up to travel and to see things and widen your world again and make you able to go and see things and do things that right now you may not feel able to.

[00:02:26] Erica: Yeah, that's why I like to bring up your adventures because I think it's really neat and I know you at one time struggled with anxiety quite a bit even as a doctor.

[00:02:36] Dr. Charles Barr: Oh, yes.

[00:02:37] Erica: It's fun. I get to see some of your adventures on Facebook sometimes and I always think Dr. Barr and his wife really value having a good time and getting out and seeing things and I enjoy seeing that.

I think it's neat.

[00:02:48] Dr. Charles Barr: Well, thank you.

[00:02:49] Erica: You're welcome.

[00:02:50] Dr. Charles Barr: We enjoy it.

[00:02:52] What does childhood anxiety look like?

[00:02:52] Erica: So today we are talking about what does anxiety in children look like. I have so many friends who have said, "you know, my kids, they act this way, they act this way. And I really don't know what to do for them."

Is that typically the kind of parents you see that come into your office? A confused parent with a child or just a parent that wants to help, but just doesn't know how?

[00:03:14] Dr. Charles Barr: Yes, very often that's the case, and sometimes they've been seeking help. They've been able to identify what the problem is, and haven't found anything that's been really effective yet.

[00:03:25] Erica: And we're going to touch on what's effective later.

[00:03:28] Dr. Charles Barr: So, children who are anxious sometimes don't present necessarily as being anxious. Sometimes they do, and sometimes they can say, you know, "Mommy, I'm scared," or, " I don't feel good," "I get shaky," or that kind of thing. But a lot of times, it presents as a stomachache, "I have a headache, I don't want to go, I don't want to do this."

A lot of people may have a shy child, and we call them shy children, and I think that's a good label sometimes and not such a good label other times. Now, there are some children who are not extroverted. That's for sure. And sometimes we'll call somebody who is more introverted shy, but that's not what really we're talking about. We're talking about children who shrink away from new things. Children who are not comfortable. They get headaches. They get stomach aches. They may have difficulty sleeping.

[00:04:30] Erica: They don't want to go to school the next day. I've noticed that's a big one.

[00:04:33] Dr. Charles Barr: Sometimes they've got school refusal and don't want to go to school. Now you may have, some of you parents, may have seen this in kindergarten when you first took your child and there was a lot of separation anxiety, a lot of crying, and a lot of, "don't leave me, don't leave me."

[00:04:53] Erica: Some of that's normal, of course.

[00:04:54] Dr. Charles Barr: It's just heart rending.

Some of that is normal. You know, they may have a couple of days of that, maybe a week of that, and then they're fine. But if it goes beyond that, then there's, there may be a another issue playing out. It's not just trying to get used to being in school and new people around and, strange surroundings, that kind of thing.

So, I want our listeners to really pay attention. If that fear lasts long or if it starts up all of a sudden. I've had some kids who they never had that kind of separation anxiety and all of a sudden clinging and not wanting to go to school and it's like, did something happen?

And the answer is yes, something has happened. it doesn't mean that something happened at school necessarily. It's that something has changed inside your child. It may be related to something that happened at school or may not be, but your child is no longer feeling comfortable and that can end up being a problem.

[00:06:02] When can it be more than "just" anxiety?

[00:06:02] Erica: When do we start examining did something actually very traumatic and life changing happen?

[00:06:08] Dr. Charles Barr: Well, I think you start looking when your child's behavior starts changing and all of a sudden you had this. You know, for those kids where it seems to start all of a sudden, then you want to be looking and you want to be talking with the teacher and with the school and see okay, what's taken place, what's going on, what's happening in the classroom, what's happening on the playground? You know, is one of the other students, there making fun of them or making them feel scared or that kind of thing.

Just start really watching, but do pay attention. It it's a very upsetting thing.

[00:06:50] Erica: And investigating caretakers and what's going on outside of school as well, I'm guessing.

[00:06:55] Dr. Charles Barr: If you can't find anything that's going on in school, you start looking elsewhere. You know, what else is going on around? Sometimes you can find something. Oh, well, there was an incident at school where somebody said something or somebody got in a fight or, The teacher may have yelled at the kids and that set off a firestorm inside the child, so it may not be a terribly awful offense from the outside, but for the child, it may have been terrifying.

And so you're trying to look for, okay, what might have terrified my child?

[00:07:30] Erica: Right. I know that my son one time said he didn't want to go to preschool, and I got a little concerned, and I talked to the teacher, and he had had some playground mishaps, and she kind of let me know all the boys, they play rough together, and that's kind of what they do. And I noticed they worked it out, and it went away. That he didn't keep saying he didn't want to go to school.

If he had kept saying that, I think that's also a thing to look at. Do they say it once they don't want to go to school, or do they say it every single day? Sunday night, does this start up again, or every, every day, is this a struggle? And if there has been a traumatic event, do they ever become more severe?

I don't know, bedwetting, or are there symptoms for trauma I guess is my question?

[00:08:17] Dr. Charles Barr: There certainly can be. If you're suspecting, any kind of sexual abuse or that kind of thing, then I think you need to involve the doctor and take your child to see the pediatrician and have them examined and make sure, everything is okay that way.

If bedwetting starts all of a sudden... now bedwetting is a fairly common event, and just because your child is wetting the bed doesn't mean that there's some huge problem,

[00:08:46] Erica: Right.

[00:08:47] Dr. Charles Barr: But when you take it into account with everything else, it might be one of those signals that you look at. And boys are more prone to bedwetting than girls are.

[00:08:58] Erica: What about sleepwalking? I've heard of quite a bit of that in children.

[00:09:03] Dr. Charles Barr: Well, sleepwalking is not necessarily connected with anxiety. Some kids have it and some don't.

[00:09:09] Erica: It's a little scary.

[00:09:10] Dr. Charles Barr: Yeah.

[00:09:11] Anxiety's Impact on a child's development

[00:09:11] Erica: Now, what about the impact of anxiety on a child's development? Because I think part of the thing is okay, once you've figured out your child has anxiety, we have to look at how is this going to affect them in the future? I know that when I saw a therapist for anxiety as an adult, one of the things she said was the reason you might need more of relaxation exercises and technique is because she said, "I suspect your nervous dysregulated for a really long time."

[00:09:46] Dr. Charles Barr: Yes.

[00:09:46] Erica: Can you touch on a little bit of the lifelong effects that we're looking at not treated right

off the bat?

[00:09:53] Dr. Charles Barr: Well, one of the interesting facts that we find is that with a lot of the adults that we end up treating for Panic disorder, when they really start understanding what panic consists of, a lot of them go all the way back into childhood and say, "Well, I used to have these kinds of feelings back when I was a kid, back when I was in school," and this kind of thing. So, a lot of the adults can trace that lineage all the way back into childhood. So we know that children are feeling those kinds of feelings, and they don't have any tools to deal with it then. So, if we can give them tools as a child, then we may save them a whole lifetime of anxiety and restriction and fear and that would be

lovely.

[00:10:45] Erica: Isn't that amazing? Yeah, that's, the goal. Unfortunately, I think so many parents are well meaning and because children are in a developmental stage, they think, "well maybe this is a stage and let's see what happens," and they're well meaning but they're ill equipped.

[00:11:05] Dr. Charles Barr: And, that's sort of right thinking for most parenting, because kids do go through stages and they do outgrow a lot of those things.

[00:11:14] Erica: Yes, fast sometimes.

[00:11:16] Dr. Charles Barr: But it's something that's chronic and it's just kind of always there, it's easy to get used to that with your child and say, "Oh, well, that's just Johnny."

You know he always does that. Well, wait a minute. Why does Johnny always do that? We want to be able to give parents some tools to use and we can start helping children learn how to have those tools as well. Children get fears, they get phobias, the same as adults do. They get scared of things.

I've had at least one child who was afraid of the Santa Annas.

[00:11:54] Erica: Oh, the winds.

[00:11:55] Dr. Charles Barr: yeah, the wind.

[00:11:56] Erica: Uh huh. For those who don't live here. Yeah.

[00:12:00] Dr. Charles Barr: Oh, that's true. If you're not in Southern California, you may not know what that is, but it's a strong wind. And there's, there's some reason to have some fear about. But you know, that had grown and grown so that any little breeze was a problem. And so isn't that just like our adult panic disorder?

[00:12:23] Erica: Yes, it just feeds off itself and it keeps growing.

[00:12:27] Dr. Charles Barr: Yes, it does, yeah.

[00:12:29] Erica: I know when I was a kid, a lot of my worries, when I look back now, I see that a lot of it was obsessive thinking. It started as a fear and it just kept going and going and going until I was thinking about it quite a bit.

 Do you see that a lot with kids they just can't seem to stop thinking? You know, it's kind of like a routine to worry about something?

[00:12:51] Dr. Charles Barr: And that worry can really build the anxiety. And so we need to watch for that kind of worry. If you find your child worrying about this, worrying about that, worrying about anything new that's going to come up or those kinds of things, pay attention. You want to make sure that they have some skills and tools to use to try to stop that worry process

[00:13:17] Erica: Just to touch a little bit on why it's important to be careful with what we say as parents in front of children, I remember as a kid, my mom was mentioning--my mom was probably, 38 years old or something --that she was mentioning that she was dyeing her gray hair and one of my friends said, "your mom is probably really old." And I remember I turned that into a worry of "if my mom's really old, she's going to die soon," And then I remember my mom thinking that was really funny because she was so young and it was just more of a joke. But kids can really... you know, you don't know what they're picking up on and there are so many TV shows and movies that parents can have on or accidentally have on. Or what parents are saying in front of kids. There are so many things kids can take and run with. So I very much agree with monitoring what kids are being exposed to, even if you think they can handle it.

[00:14:13] Dr. Charles Barr: Yes, and, one of my grandchildren was over here and the news came on. We usually don't watch the news with them at this point, because they actually get concerned and frightened by the news.

And so he came running out saying, "Grandpa! Grandpa! There's breaking news! Come quick! Come quick!" You know, and it's urgent for them in their view, you know, and from our view, it's a much different. way to look at these things. And we have to remember that. Then, another thing is, one time my son got choked on a piece of meat and we were meat dislodged, but that was very scary, and I remember saying to him, you have to chew your food really well so it won't get stuck.

Well, then, we noticed over the next week or so, it's like, "Why is he taking so long to eat?" He's still sitting at the table for another 30 minutes, just barely getting any of his food eaten.

And it finally dawned on me, well, when did all this start? And we tagged it back to that event, and to what I had said to him.

And He was chewing his food until it was almost digested before he would swallow it.

[00:15:29] Erica: Poor guy.

[00:15:31] Dr. Charles Barr: So we had to go back and redo that. that,

[00:15:33] Erica: Yeah, I know. And right now, I'm talking to my son. He's really into bad guys and good guys. And so a lot of the talk is, okay, what happens if somebody comes and says they know your mommy and to come with them because they have these toys in their car, or they've got some puppies to pet or whatever.

And what do you do? And, it's like, well, you say no and you run or whatever. These are real conversations I have to have with a four year old, unfortunately. But we have them and there's always a part of me that's like, "Oh, I hope I'm not scaring him to death," you know?

But it's that fine line of making your kid aware enough and, trying not to make it terrifying.

[00:16:16] Dr. Charles Barr: And it's, a fine line to walk and you reinforce it over and over again. Yeah, it's very, very scary. You have to use good sense, and you have to be cautious sometimes, but it's a beautiful world, and there are a lot of good people in it.

Boy, the bad sure screw it up for us.

[00:16:35] Introducing: Life Skills for Kids

[00:16:35] Erica: Right. Definitely. So we are in the final stages of bringing the classic LifeSkills for Kids program back. I'm really excited. This is a kind of the little brother and sister to the CHAANGE Anxiety Treatment Program. Dr. Barr has used it, with how many kids do you think you've used it with?

[00:16:53] Dr. Charles Barr: Oh, over a hundred. I don't know. Somewhere in there,

[00:16:57] Erica: And what were the results like? I think they probably were

pretty good.

[00:17:01] Dr. Charles Barr: Oh, they're excellent results. What is so encouraging is that then you get to see, children master their fears. And go ahead and start having new behaviors and try new things and, you can just see the cloud lift. They know how to regulate their own feelings.

They know how to manage that fear. And, yes, they have to practice the same as adults do, but of course a little differently because, they're children. But, feeling some self mastery and they have some control over what's going on in their bodies. And that really helps further their learning.

A very good program. It's well thought out. It's based on proven techniques that we know work. And that's all what we really are looking for.

[00:17:51] Erica: Yes, and like the CHAANGE Anxiety Treatment Program, we did not recently come up with this. This is something that's been used for over, I guess for over 30 years as well, right?

[00:18:01] Dr. Charles Barr: Yes.

[00:18:03] Erica: Yes. So, , Dr. Barr has overseen many cases. We've got a nice little workbook and some things that are really broken down for kids and stuff that kids can do with their parents.

And we're going to discuss more in the next episode, but if you do want to find out more now, head to lifefreeofanxiety.com/kids. And I feel really good about bringing this out. I'm very excited. There is a lot of stress in the world and we forget sometimes it's not just the adults having it.

[00:18:33] Dr. Charles Barr: Well, and COVID era. A lot of our kids really got very frightened by COVID.

[00:18:39] Erica: Yeah,

[00:18:40] Dr. Charles Barr: And rightfully so. It was it was a frightening time and frightening stuff going on. And a lot of the kids got frightened by that. And some of them are having a hard time coming out of that. And if we can give them some help with that, as well as manage feelings of social anxiety and how to regulate those fears when they show up and that kind of thing, then, then that is such a help to them in their whole lives.

[00:19:07] Erica: Yeah, I can just imagine the success stories you've seen in your own office and I'm excited to get those emails in where people are telling me my kid's doing so much better. There's nothing more rewarding than that.

[00:19:18] Dr. Charles Barr: Well, it is very rewarding. It's very rewarding as a therapist. It's very rewarding as a parent. And when you know you're doing something good for your children, it's always nice to feel like a good parent.

[00:19:31] Erica: Yes, yes, it's always nice.

[00:19:34] Dr. Charles Barr: And there's enough, when you don't know whether you're being a good parent or not.

And this doesn't have to be one of those.

[00:19:40] Erica: Yeah, and I know we were talking about separation anxiety earlier. I was gonna say, is there any kind of therapy for the parent who drops off their two and a half year old son to preschool and the son doesn't want to go with them? He was having so much fun when they pick him up. That's what happened to me. I was like, what? Okay, I've heard about what to do when they don't want to go to school. What about when they don't want to come home

[00:20:05] Dr. Charles Barr: with Yeah, that's right. a different kind of trauma, isn't it?

[00:20:10] Erica: I think though, he was born in the COVID era and he really hadn't seen many kids and he loves toys and there was, a room full of toys to explore and that was good enough for

[00:20:22] Dr. Charles Barr: him.

Absolutely. Yeah. Don't take it personally.

[00:20:26] Erica: Okay, I'll try not to. He's a little bit, not as excited. He loves school now but he's not as enthusiastic so it was it was fun while it lasted.

[00:20:36] Dr. Charles Barr: Oh, that's funny.

[00:20:38] Erica: Well, I guess that's it for now. Next week, we are going to talk more about intervention. Dr. Barr, you had some great points today about lifelong effects of anxiety. Nobody, no parent wants to see their child take that into adulthood. So, we're going to dive deeper into intervening, what you can do as a parent, and we've got some good stuff ahead, and also we're going to talk to you more about the LifeSkills Program.  

[00:21:02] Dr. Charles Barr: Absolutely.

[00:21:04] Erica: I think that's about it. So we hope you enjoyed this. Dr. Barr, thanks for being my co-host. It's always a pleasure,

[00:21:12] Dr. Charles Barr: Always a pleasure to be here with you, and we look forward to giving you some more information next time.

[00:21:19] OUTRO

[00:21:19] Erica: Thanks so much for tuning in today. I hope that something in today's conversation provided you with a feeling of hope, determination, or purpose. I know what you're going through, and that's why I want to give you some of the tools that helped me in my anxiety journey. To get a free copy of Free From Fears head to freefromfearsbook.com to find out more about the CHAANGE Anxiety Treatment Program.

Find us at CHAANGE.com Thanks again for listening.

And remember you are not broken. You are not alone. And you are on your way to living a life free of anxiety. See you next week