Understanding Anxiety in Kids and Teens

October 14, 2022by Balance Kids
Anxiety is the body’s normal stress response. Learn how anxiety can be managed and treated when it becomes too much.

As a parent, teacher, babysitter, or even neighbor, you may notice behavior that concerns you. Though you may not be able to immediately identify it, you know something is not right.

Anxiety in children can show up in different ways, such as avoidance of activities or experiences, irritability, and difficulty sleeping. All of these things may point to an issue larger than “kids being kids.”

But what is anxiety—and what causes it in kids? What symptoms should you be looking for? And how can it be successfully managed?

Keep Reading To Learn

  • How anxiety presents itself in kids and teens
  • Understanding the types of anxiety and symptoms
  • How anxiety is treated in kids and teens

Understanding Mental Health in Children and Teens

Mental health challenges may come about as a reaction to environmental stressors, including trauma, the death of a loved one, school issues, and/or experiencing bullying. All these factors—and more—can lead to anxiety in kids and adolescents.

Noticing changes in children and teens is crucial, as symptoms of most mental health challenges start before age 25. It’s critical to address these concerns as soon as possible: The quicker we address the problem, the better chance a young person can return to everyday activities.

Anxiety disorders have the potential to affect every part of a young person’s life, including their physical health, emotional well-being and social skill development. The combined impact can lead to kids feeling socially isolated, stigmatized, and incapable of being active members of their community.

Mental health has a direct relationship with a child’s physical health. Both physical and mental health influence how children think, feel, and act on both the inside and out.

Mental Wellness for Kids and Teens

Balance Kids, Mental Health programs for kids ages 6-11 discusses the importance of mental wellness in children and adolescents and answers audience questions about child and teen mental health.

Watch Now!  Balance Kids commercial…. Really good.

Anxiety Can Develop in Anyone at Any Time

Anxiety is the most common mental health disorder. It affects millions of young people in the United States.

Anxiety disorders are often exhibited as excessive worry about daily events or activities (e.g., work or homework) that occurs more frequently than not and interferes with educational, occupational, and/or social lives.

How common is anxiety in young people?

  • Research done by the National Research Council and Institute of Medicine revealed an estimated 32% of adolescents living in the U.S. experienced an anxiety disorder
  • Although anxiety disorders occur more often in females than males, age, ethnicity, and geography play no role in who develops anxiety
  • Unfortunately, only 7% of young people who need mental health help receive it

Not All Anxiety Is the Same

Anxiety is the body’s normal stress response. However, children who struggle with clinical anxiety encounter interference in their daily social, academic, or home lives. Though anxiety is a universal emotional experience, excess anxiety can indicate there’s a problem that needs to be addressed.

It can be difficult to determine the type of anxiety someone is experiencing. Some anxieties are short-term and situational, while others are sudden and inexplicable.

Learning the difference between stress, fear, uncertainty, panic, and social anxiety can help with understanding someone’s anxiety signs and symptoms.

Stress vs. Anxiety

Stress, like anxiety, is an emotional response. Stress is usually caused by an external trigger, like taking an exam or getting into a fight with a friend. Anxiety, on the other hand, can be an internally created fear that seems to take on a life of its own. Both have a similar set of symptoms: fatigue, difficulty concentrating, anger or irritability, and trouble with sleeping. Unlike stress, clinical anxiety is not short-term and does not go away after the stressor is taken away.

Fear vs. Anxiety

Fear is the emotional response to a real or perceived threat. Anxiety is the anticipation of a future threat. People also use the word “anxiety” to describe lingering nervousness or a constant sense of tension or worry.


Anxious individuals tend to have an intolerance for uncertainty. Sometimes people with anxiety call this “fear of the unknown.” Those who chronically worry equate uncertainty with bad outcomes. To lower the risk of a future threat, people with anxiety may try to minimize the number of uncertain situations they encounter. This avoidance strengthens anxiety in the long run.


A panic attack is a surge of anxiety that peaks between 10 and 30 minutes and includes at least several physical symptoms, such as a racing heart or shortness of breath. Panic attacks can come out of the blue or have an identifiable trigger.

Those with panic disorder experience panic attacks that come out of the blue and fear having panic attacks in the future. They also may start to avoid situations in which they think they may have a panic attack.

Often individuals with panic disorder feel as if they are losing control, having a heart attack, or going to die.

Some of the physical symptoms of panic disorder include:

  • Rapid heartbeat
  • Sweating
  • Chest pain
  • Shortness of breath
  • Dizziness
  • Stomach distress

How do panic and anxiety differ? Whether unprovoked or triggered, panic attacks happen quickly and reach their climax within minutes. Anxiety may appear gradually and last for extended periods of time.

Social Anxiety

Social anxiety disorder is a fear of being judged or embarrassed in social situations. In children, social anxiety often happens in peer settings, including school and extracurriculars. It may also occur when interacting with adults or members of authority.

The core of social anxiety in kids and teens is a worry of being negatively evaluated by others in social situations. Their concern may be that others are judging them as anxious, weak, dumb, dull, intimidating, filthy, or unlikeable.

Some children and teens have the fear of offending others and feeling rejected as a result. Children who experience social anxiety may avoid a range of social experiences, such as participating in class, eating in front of others, participating in extracurricular activities, ordering in restaurants, using public bathrooms, and going to social events with peers.

Some of the hallmark symptoms of social anxiety are:

  • Blushing
  • Trembling
  • Stammering or stuttering
  • Sweating
  • Staring
  • Crying or throwing a tantrum
  • Freezing in place
  • Clinging to a peer or parent
  • Shrinking back to make oneself less noticeable

With social anxiety, extensive avoidance of social situations occurs. Often the person’s intense fear and anxiety increases the more they avoid the situation. Chronic social anxiety often lasts, at a minimum, six months. Social anxiety disorder symptoms have to persist for at least six months before a diagnosis is considered.

Separation Anxiety

Separation anxiety disorder is one of the most common anxiety disorders in kids. It involves a worry that something bad will happen to the child or caregiver upon separation.

This can lead to excess worry, sleep issues, social distress, physical symptoms of anxiety, or difficulty in school.

Typically, separation anxiety peaks at three years old. As kids’ brain function continues to develop, they can better understand that separation from an attachment figure is not permanent. In addition, the older they get, the more independent they become.

With separation anxiety disorder, though, this worry does not diminish and may intensify.


Phobias are fears of objects or situations. This type of anxiety can be disruptive to a person’s life. Some very common phobias in kids and teens are:

  • Hemophobia (fear of blood)
  • Emetophobia (fear of vomiting or seeing others vomit)
  • Trypanophobia (fear of needles or medical procedures involving injections/hypodermic needles)

Fear associated with phobias happens very quickly. This anxiety is usually present for six months or longer.

Selective Mutism

Selective mutism involves a child’s difficulty speaking in one or more social settings, such as at school or in public venues, even though the child speaks freely in other settings, such as at home with family.

Although children with selective mutism have language skills, anxiety often makes it challenging for children with selective mutism to speak to others outside of the home.

What You Really Don’t Know About Anxiety

Although the word “anxiety” is commonly used, it’s still a very misunderstood condition. To better understand anxiety in kids and teens, it’s important to know what anxiety is and what it isn’t. Here are some common myths about anxiety.

How Can I Tell if a Child or Teen Has Anxiety?

While there are general symptoms of anxiety, a child or adolescent may not have every symptom or have any visible symptoms.

Physical symptoms of anxiety may include:

  • Consistent stomach aches or headaches
  • Racing heart
  • Shortness of breath
  • Gastrointestinal issues, including, but not limited to, nausea and vomiting
  • Irritable or easily agitated
  • Sleeping too little
  • Having frequent nightmares
  • Low energy
  • Constantly moving or being unable to sit still
  • Frequent tantrums 

Emotional and behavioral symptoms may include:

  • Constantly discussing fears and worries
  • Spending increased time alone, or avoiding social events
  • Worsening educational performance, including skipping classes or the school day altogether

When Should I Seek Help?

If you think that your child or teen is being avoidant and/or extremely distressed, it’s important to seek help to assist with identifying the problem and developing successful coping strategies. The sooner you seek care for a young person, the better chance they have for a positive outcome.

If you think a child or adolescent needs help, please reach out to their pediatrician or a local mental health provider, Balance Kids.