Five Signs of Childhood Anxiety and How Parents Can Help

01
The essence of anxiety is an emotional response, typically associated with uncertainty, risk, and a sense of threat. It is a natural psychological reaction that human beings experience when facing pressure and challenges, designed to alert us to potential dangers or difficulties and to prompt us to take action to cope with these situations. Like other human emotions, anxiety is perfectly normal. However, excessive anxiety can bring unnecessary trouble to our lives.

From a biological perspective, anxiety is linked to an imbalance of neurotransmitters in the brain, particularly gamma‑aminobutyric acid (GABA), serotonin, norepinephrine, and other substances. These neurotransmitters play important roles in regulating mood, behavior, and cognition. When they are out of balance, emotional regulation may become disrupted, giving rise to anxiety.

From a psychological perspective, when an individual perceives a situation as threatening, an automatic stress response is triggered, leading to feelings of anxiety. In addition, how the individual interprets the situation and copes with it also affects the level of anxiety. For example, cognitive biases such as excessive worry about matters, pessimistic interpretation, and negative expectations are major causes of anxiety. Psychologists have introduced the concept of "intolerance of uncertainty," suggesting that the greater the uncertainty, the higher the individual’s anxiety level.

Individuals with perfectionistic tendencies and excessively high self‑expectations are demanding of themselves and their environment. Once they fail to meet their own standards or encounter setbacks, they are prone to anxiety. Meanwhile, those with low self‑esteem or lack of confidence are more likely to feel helpless when facing challenges and difficulties. They may doubt their own abilities, which further intensifies their anxiety.

02
Excessive anxiety is a common but often misunderstood or overlooked issue in children. Like adults, children can experience worry, fear, and nervousness, but they may not always be able to express their feelings in words or emotions. Especially in the reality of high academic pressure and intense competition, many children develop psychological problems due to excessive anxiety. As parents, it is important to recognise the signs of anxiety in your child and provide the right support to help them cope.

Five common symptoms of anxiety in children:

• Excessive worry or fear

• Physical symptoms (headaches, stomach aches, or fatigue)

• Difficulty concentrating or avoiding tasks

• Social withdrawal

• Sleep problems (nightmares or difficulty sleeping)

Excessive worry or fear
a) Specific manifestations: Some children show frequent and intense worry about things that adults may consider trivial—for example, fear of participating in social activities, anxiety over exam results, or even fear about small everyday matters. Such excessive worry is often not limited to specific situations but may spread across many areas of life. These worries often evolve into persistent negative thought patterns, where the child always imagines the worst‑case scenario or fears catastrophic outcomes that are almost impossible.
b) How to help:

• Listen and understand: When your child tells you about their worries, listen attentively without immediately interrupting or dismissing them. However, many parents often say, "What’s there to be afraid of?" or "It’s no big deal." When children hear this, they feel deeply misunderstood. Over time, they will close their hearts to you, which can become troublesome during adolescence. Instead, you can tell them:

• Give reassurance: When comforting your child, avoid simply saying, "It’s okay," which is perhaps the most common parental response. The right approach is to say, "I understand you’re worried right now. Let’s look together at what’s making you so tense," or "I know you’re scared, but you actually have the ability to face these challenges. I believe in you."

• Teach coping methods: Help your child learn relaxation techniques, such as deep breathing, meditation, or breaking a big problem into smaller parts and solving it step by step, to reduce their anxiety.

Physical symptoms (headaches, stomach aches, or fatigue)
a) Specific manifestations: Anxiety often manifests through physical symptoms. Children may frequently complain of stomach aches, headaches, muscle tension, or unusual fatigue. Some children are fine normally but develop stomach aches or headaches right before exams or the start of school. Parents often think the child is pretending to avoid exams or school. Yet medical check‑ups reveal no physical issues—this may actually be a sign of anxiety. Some children also bite their nails or often say, "I’m so tired," which is common among primary and secondary school students.
b) How to help:

• Rule out physical causes: First, ensure that your child has no underlying physical health problems. Consult a doctor to rule out any possible physiological causes. If symptoms are related to anxiety, shift focus to the child’s emotional and mental health.

• Teach relaxation techniques: Use deep breathing, meditation, or progressive muscle relaxation to help your child relax both mind and body, relieving physical tension.

• Establish healthy routines: Set a regular sleep and rest schedule for your child, especially before stressful situations, to ensure they get enough rest, which helps reduce physical discomfort caused by anxiety.

Difficulty concentrating or avoiding tasks
a) Specific manifestations: Anxious children often have trouble concentrating, especially when faced with tasks that make them uneasy or fearful. For instance, a child may worry that their homework won’t be good enough, so they keep putting it off or even avoid doing it altogether. This distraction and task avoidance can intensify anxiety, creating a vicious cycle.
b) How to help:

• Break down tasks: Divide a large task into several small parts, and give encouragement after each small part is completed. This way, the child won’t feel overwhelmed, and the pressure is reduced. As they gradually complete what seemed like an impossible big task through small steps, they not only learn problem‑solving skills but also build courage to overcome difficulties.

• Set small goals: Encourage your child to set small goals, with a break after each one. Achieving these goals step by step helps boost their confidence. Each small sense of accomplishment will stimulate their intrinsic motivation.

• Praise effort, not just results: Even if the task is not yet finished, praise your child’s effort. Let them know that every step of progress matters, not only the final outcome. If parents focus excessively on results, children will do the same, neglecting the process of effort. But we all know that effort does not always guarantee good results. When a poor outcome occurs, the child may find it hard to accept, leading to frustration and anxiety.

Social withdrawal
a) Specific manifestations: Anxious children may feel unwelcome in groups, overwhelmed in social settings, become shy, or withdraw from activities. They may fear interacting with peers and stay away from classmates. As a result, they try to avoid social occasions, even being afraid to go to school or attend parties and group activities. In this way, they miss many opportunities to practise social skills and may become increasingly lonely.
b) How to help:

• Validate their feelings: Help your child understand that it is normal to feel socially nervous—everyone experiences such moments. By acknowledging their emotions, you reduce their sense of isolation and strengthen their self‑confidence.

• Gradual exposure to social settings: Start with a small‑scale activity, such as inviting one friend over to play, then slowly encourage them to join larger gatherings.

• Role‑play: Practise social scenarios with your child through role‑play, helping them rehearse how to greet others and start conversations. This way, they will feel more natural in real social situations.

Sleep problems (nightmares or difficulty sleeping)
a) Specific manifestations: Anxiety can interfere with a child’s sleep quality. They may have trouble falling asleep due to worries about the next day, wake up in the middle of the night, or frequently have fear‑related nightmares. Lack of good rest not only affects physical health but also makes emotions more volatile and anxiety worse.
b) How to help:

• Establish a calming bedtime routine: Engage in relaxing activities before bed, such as reading, taking a bath, or listening to soft music, to help your child unwind and set the stage for good sleep.

• Avoid pre‑sleep stressors: Try to avoid stressful discussions or activities right before bedtime. If they are worried about something, address it earlier in the day so it doesn’t linger in their mind. Admittedly, with children’s heavy academic schedules and parents’ busy work, bedtime may be the only time for family communication. Even so, parents should hold back and save potentially stressful conversations for the morning.

• Soothe nighttime fears: For children who frequently have nightmares or are afraid at night, create a comfortable and safe environment. A night light, a comforting object (like a stuffed animal), or even a special bedtime ritual can provide reassurance.