What Does Anxiety Look Like In Children?

If your child feels anxious most of the time, or if her anxiety is disproportionate to the situation, you may be dealing with a bigger problem than standard nerves. Learn how to recognize primary and secondary anxiety in a child who may also have ADHD.

A young child hugging his mother and exhibiting strong signs of anxiety.
Child in orange shirt hugging mother in maroon shirt
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Anxiety is Normal

Stress and anxiety are a normal part of life for children and adults. Moderate anxiety helps children push themselves to succeed at home and in school. It is normal to feel anxious when taking a test or performing in the school play. We expect children to be nervous at the doctor’s office or when faced with a new situation. But when children are anxious all the time, or when their anxiety is disproportionate to the situation, there may be a bigger problem.

[Self-Test: Does My Child Have Generalized Anxiety Disorder?]

A doctor diagnosing a young girl with anxiety
Doctor using stethoscope on young girl in pink shirt
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Primary or Secondary?

Seeking an accurate diagnosis is the first step to developing an appropriate treatment plan for anxiety. A doctor should determine whether the anxiety is primary or secondary. If a child has had difficulty regulating stress and anxiety since early childhood, and his anxiety is pervasive, it is primary. On the other hand, an anxiety disorder can be caused by difficulties related to ADHD or a learning disability. This type of anxiety is thought to be secondary to the other disorder.

[Read: ADHD & Anxiety Checklist for Children]

A doctor discussing anxiety with a young child
Doctor and patient
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How to Treat?

For children whose anxiety is secondary to their ADHD, treatment might ultimately include behavioral therapy, medication, or family counseling. But before looking into those options, there are a few simple techniques parents can try that are effective for many children who struggle with ADHD and anxiety.

[Free Resource: Is It More Than Just ADHD?]

A ADHD young boy with anxiety crying outdoors
Young ADHD boy crying outdoors
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Try to Understand the Fears

Before you try and "fix" the fear, listen carefully to your child as she explains what's bothering her. Don't jump to conclusions — and don't assume that saying, "Don't worry" will help. For children too young to articulate fears, it may be helpful to have them draw a picture.

A young boy discussing his anxiety with his father
Young boy talking to father in pajamas
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Ask the Child to Consider the Fear in Detail

You might ask him to rate his fear on a 10-point scale, or ask him what triggers the scary thoughts. Does anger or loneliness accompany the fear? Do not discount the worry. Acknowledge the feelings while giving the child information; age-appropriate books on the worrisome topic can help.

A girl talking to a puppet, a good tool to manage anxiety in young children
Girl talking to puppet on her hand
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Devise a Technique the Child Can Use

Your child might imagine writing words on a blackboard — and then erasing them. Or he might imagine burying words in a hole or sealing them in a rocket and then blasting it into space. A younger child might feel better by having a favorite puppet repeat "Be gone" or another incantation.

Mother and daughter hugging on porchswing to help the child manage anxiety
Mother and daughter hugging on porch swing, yellow and orange shirts
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Ask the Child How They'd Make the Situation Less Fearsome

If a child dreads a social event because "no one I know will be there," you might offer to invite a friend to come along. Or you might devise an early exit plan, which can give a child some control over the situation. Talking to your child beforehand can help him sail smoothly through a potential rough spot.

Young child hugging a puppy to help calm anxiety
Girl in pink shirt hugging puppy
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Teach the Child Relaxation Techniques

Yoga, deep breathing, and other self-calming techniques are highly effective. Look into classes for kids offered in your area. Some kids have developed their own ways to calm themselves when worry strikes — hugging a pillow, playing with a pet, or simply holding a favorite toy. Ultimately, it's up to the child to curb his own anxiety.

[Up Next: Treatment for the Symptoms of Anxiety Disorders]