Anxiety, worries and fear: a natural part of childhood

Anxiety is the feeling of worry or fear that something bad is going to happen. It’s also the physical reactions that go with the feeling, like ‘butterflies in the stomach’. And it’s behaviour like avoiding what’s causing the anxiety or wanting a lot of reassurance.

Anxiety, worry and fear are natural emotions.

It’s common for children to feel anxious, worried or afraid. In most cases, these feelings come and go and don’t last long. In fact, different anxieties, fears and worries often develop at different stages of development.

Babies and toddlers are often anxious about separation from you. They also fear things like loud noises, heights and strangers. But babies and toddlers don’t tend to worry in the way that older children do.

Preschoolers might start to show fear of being on their own and of the dark. But worry still isn’t common in this age group. If preschoolers do worry, it tends to be about things like getting sick or hurt.

School-age children might be afraid of supernatural things like ghosts, social situations, criticism, tests and physical harm or threat. Children over 8 years of age might worry about things like failure at sport or school, war, pandemics, the environment and family relationships.

Worry usually happens when a child thinks about past or future situations. Fear usually happens in the present. For example, a child might worry about visiting a friend with a pet dog and then be fearful when they see the dog.

What to do when children are anxious

If you think your child is showing signs of typical childhood anxiety, worries or fears, you can support them in several ways:

• Acknowledge your child’s fear or worry, and let them know that most people feel anxious sometimes.
• Talk with your child about their worries.
• Gently encourage and support your child to face situations they’re anxious about, starting with situations that cause the least anxiety.
• Wait until your child gets anxious before you step in to help.
• Praise your child for doing something they’re anxious about.
• Avoid criticising your child for being afraid or worried.
• Avoid labelling your child as ‘shy’ or ‘anxious’.
• Make sure your child eats healthy food, does enough physical activity and gets the sleep they need. Good physical health is important for mental health.

Read about the stepladder approach, a gentle behaviour technique that you can use to help children manage anxiety.

When to be concerned about anxiety in children

Most children have fears or worries of some kind. But if you’re concerned about your child’s fears, worries or anxiety, it’s a good idea to seek professional help.

Here’s when to see your GP or another health professional:

• Your child’s anxiety is stopping them from doing things they want to do or interfering with their friendships, play, schoolwork or family life.
• Your child’s behaviour is very different from children the same age. For example, it’s common for most children to have separation fears when going to preschool for the first time, but separation anxiety is far less common over the age of 8 years.
• Your child’s reactions seem unusually severe. For example, your child might be very distressed or very hard to settle when they’re anxious or worried.

Anxiety disorders in children

Severe anxiety can affect children’s health and happiness.

Some anxious children will grow out of their fears, but others will keep having trouble with anxiety unless they get professional help. When children’s anxiety affects their lives and is severe or long-lasting, it might be an anxiety disorder.

These are the most common types of anxiety disorders in children:

• Social anxiety – this is intense fear of social situations or being judged or embarrassed in public. It can also include intense worry or ‘fear of missing out’ or not being included.
• Separation anxiety – this is intense fear of being separated from parents or carers.
• Generalised anxiety – this is intense worry about many areas of life.
• Selective mutism – this is when children can’t speak in certain places, with certain people or during certain social activities.

You can be a role model for your child by managing your own anxiety. You can also help your child see that anxiety in itself isn’t bad. It’s only a problem when it stops us from doing what we want or need to do.

Professional help and treatment for children with anxiety disorders

Children with anxiety disorders and other mental health problems usually respond very well to professional treatment.

You can seek professional information and advice from several sources, including:

• your child’s teacher at preschool or school, or a school counsellor
• your child’s GP or paediatrician, who can refer you to an appropriate mental health professional
• your local children’s health centre or community health centre
• a specialist anxiety clinic (available in most states)
• your local mental health service.

There are also online programs to help children manage anxiety – for example, The BRAVE Program.

If your child is aged 5 years or older, they can talk with a counsellor at Kids Helpline by calling 1800 551 800 or using the Kids Helpline webchat counselling service.

Financial support for children with anxiety disorders

Your child might be able to get Medicare rebates for up to 10 sessions with a psychologist, a social worker or an occupational therapist each calendar year.

To get these rebates, your child will need a mental health treatment plan from a GP (this covers the services your child needs and the goals of the treatment), or a referral from a psychiatrist or paediatrician.

Severe anxiety can sometimes be caused by an underlying medical condition. If your child is experiencing severe anxiety, it’s a good idea to talk to your GP or another health professional.