Anxiety in childhood often hides in plain sight. It rarely looks like worry the way adults experience it. Instead, it appears as stomach aches before school, clinginess, irritability, perfectionism, sudden tears, or refusal to attend classes. Many anxious children are mislabelled as “stubborn,” “disobedient,” “slow,” or “overly sensitive,” when in reality their minds are working twice as hard to cope.

Childhood anxiety is not a sign of weakness—it is a sign of a nervous system seeking safety.

How anxiety shows up in children

Children express anxiety through behaviour more than words. Some patterns to look for include:

• School refusal or morning distress

• Night-time fears, repeated checking, sleeping with parents

• Irritability and anger (anxiety often hides behind anger)

• Frequent stomach aches or headaches

• Avoidance of social situations

• Fear of making mistakes, perfectionistic tendencies

• Clinginess, difficulty separating from parents

• Excessive reassurance seeking

• Sudden withdrawal or daydreaming

These signs are the child’s way of communicating: “I don’t feel safe.”

Why anxiety increases during the school years

The school environment places demands the child has not faced before:

• navigating friendships,

• handling competition,

• dealing with comparisons,

• managing homework and deadlines,

• coping with loud, unpredictable sensory input,

• facing separation from parents for long hours.

Children with sensitive temperaments or neurodivergent traits (ADHD, ASD, SLD) find this especially overwhelming.

Their emotional “alarm system” stays switched on.

Where anxiety comes from

Childhood anxiety grows from a combination of:

1. Temperament

Some children are born sensitive or cautious.

2. Family environment

Parental stress, conflict, overprotection, or high expectations can influence anxiety.

3. School pressures

Academic load, bullying, strict teachers, comparisons, and performance anxiety.

4. Neurodevelopmental conditions

Attention or learning issues increase daily stress and self-doubt.

5. Traumatic or stressful events

Loss, sudden changes, illness, or unsafe environments.

Anxiety is rarely “just in the child.” It is a dance between the child’s temperament and their environment.

How to help: calm the worry, support the child

1. Emotional safety first

Children settle when they feel seen and understood.
Simple steps like validating their fear (“I know school feels scary right now”) lower anxiety dramatically.

2. Gradual exposure, not avoidance

Avoiding the feared situation gives temporary relief but strengthens the anxiety.
With support, children can return step-by-step:

• entering the school gate,

• spending an hour in class,

• meeting one friendly teacher,

• gradually rebuilding confidence.

3. Establish predictable routines

Regular sleep, meals, and study-time reduce internal chaos. Predictability is soothing for anxious minds.

4. Teach calming tools

Age-appropriate strategies work beautifully:

• slow breathing,

• grounding exercises,

• worry journalling,

• visualisation,

• progressive muscle relaxation.

These give children a sense of control over their inner world.

5. Parent guidance

Parents learn:

• how not to unintentionally reinforce fear,

• how to respond calmly during meltdowns,

• how to model coping skills,

• how to reduce pressure and increase connection.

6. School collaboration

Teachers often see patterns parents miss.
Supportive teachers create a safe environment and help the child settle gradually.

7. Therapy for deeper anxieties

Cognitive-behavioural techniques, play therapy, and social skills training help children reshape their thoughts and reactions.

8. Medication is rarely first-line—but sometimes helpful

When anxiety severely affects sleep, eating, functioning, or leads to school dropout, medication may be used carefully and temporarily.
The goal is not to sedate; it is to help the child re-engage with life.

Anxiety is treatable—and children bounce back quickly

Children respond remarkably well to early intervention because their brains are flexible and emotionally responsive.
With the right support, anxious children grow into emotionally intelligent, resilient adults.

A child’s anxiety is not a failure of parenting—it is an invitation to strengthen the entire support system around them.

This series continues to simplify these journeys and offer families science-backed clarity and hope.

Author & Contact

Dr. Srinivas Rajkumar T, MD (AIIMS), DNB, MBA (BITS Pilani)
Consultant Psychiatrist & Neurofeedback Specialist
Mind & Memory Clinic, Apollo Clinic Velachery (Opp. Phoenix Mall)
✉ srinivasaiims@gmail.com 📞 +91-8595155808