Unexpected Signs of Child Anxiety & What to Do About It
Anxiety is one of the most common mental health diagnoses in children. In fact, according to data reported by the CDC for 2023-2024 11% of children age 3-17 had a diagnosis of Anxiety. When thinking of a child with anxiety, you may think of a quiet, tearful or avoidant child. In fact, Piglet from Whinnie the Pooh may come to mind. Through my time working with school-aged kids I’ve come to know that anxiety often shows up in less obvious ways first.
I begin to suspect anxiety when I see things like; worksheets being ripped up, frequent visits to the nurse, complaints of being tired and an increase in peer conflict or avoidance. On the other hand, it can often go unnoticed at school and show up with a bang at home. Parents will begin to report an increase in meltdowns, refusal, and forgetfulness. Anxiety can show up in so many unexpected ways, it’s no wonder it can be so difficult for a child to articulate.
It’s helpful to remember that anxiety is a nervous system on high alert. Meaning it comes out in the fight, flight, freeze, or fawn reactions. The body can’t recognize the difference between real danger and a test, it reacts the same.
Fight- Irritability, anger, meltdowns
Flight- Avoidance, refusal
Freeze- shutting down, silence
Fawn- Seeking reassurance or people pleasing.
From the outside these don’t scream “worry”, but that is often what is going on underneath.
Unexpected Signs
Physical complaints with no clear cause. Stomachaches, headaches, or "I don't feel good" that disappear when the trigger dissipates. This might show up before school, before a big test, sporting event, or even during the school day. This is one of the most common signs I see, and it's not the child faking it. Anxiety is physical; the body reacts before the brain has words for what's going on.
Anger outbursts. Getting out at recess or a wrong answer on homework turns into a full-blown meltdown. Irritability is often anxiety's disguise, especially in kids who don't have another outlet for the feelings building up inside them.
Perfectionism. The constant erasing of schoolwork, the crumpled-up drawing, the refusal to keep playing a game after one wrong move. This is often less about wanting things "right" and more about a fear of getting things wrong.
Sleep issues. This is so similar to adults! The quiet of bedtime can often get minds racing. Bedtime stalling or refusal can be an indicator of something bigger going on. If your child seems to be sleeping fine but also complaining of being tired, it could be anxiety as well. Frequent wakeups, nightmares, restless sleep and the exhaustion of a body on alert all day can really add up.
Focus concerns. Here is where parents start to have concerns for ADHD. A worried mind struggles to stay on task. So, your child might be taking ages to complete homework or start missing assignments in the classroom.
Dislikes. "I hate that class" or "I don't want to go to soccer anymore" can sound like a preference, but it's worth a second look if it's a sudden or intense shift. Kids often express fear as dislike because "I hate it" is easier to say than "it scares me."
Appetite changes. A stressed out nervous system doesn't prioritize digestion. Skipping meals, a shrinking list of "safe" foods, or a stomach that "just isn't hungry" on school mornings can all be tied to anxiety.
A need for control. Wanting routines followed exactly, getting upset when things happen "out of order," or needing to know the plan for every part of the day. When the world feels unpredictable, controlling the small stuff can feel like the only lever a child has.
Hyperfixations. The NEED to look something up, finish something before moving on, or extended deep interest in a specific thing (animals, time periods, video game). Many of which are developmentally appropriate- but can also be a child seeking control to reduce the anxiety that comes with the unknown.
Outfit needs. Oftentimes a reaction to anxiety can look like seeking comfort in clothing choices. Insisting on the same outfit over and over or refusal to take off their coat inside are often clues that a child is feeling nervous or on edge.
School & home difference
Teachers and parents often see different versions of the same child. A kid can hold it together for six hours at school and then fall apart the second they're home. Which makes sense because let’s be honest, home is safe and we would certainly be exhausted after that type of day. That means the signs above can show up differently depending on the environment. Children can easily get mislabeled with "behavior problems," defiance or even ADHD, when anxiety is the actual cause.
If a child's struggles look different at school than at home, or if a teacher and a parent are describing what seems like two different kids, it’s always important to note. It’s not a huge red flag, but useful information to keep track of.
What can you do?
Name the feeling out loud. "It looks like your body might be feeling worried right now" gives kids language for something they may not have words for yet. Over time, that vocabulary helps them recognize and communicate what's happening instead of it coming out in these unexpected ways.
Normalize it. When your child is able to share that something is worrying them or able to agree that maybe it could be a fear, do your best to validate. “That sounds scary” is going to be more supportive than “don’t worry”. Even though we can’t always understand why a child is worried about something, what they need to know is that it makes sense to someone.
Support when it persists. An occasional rough night or a clingy morning is normal kid stuff. But when these signs are frequent, intense, or getting in the way of daily life (school, sleep, friendships) it's worth talking to a school counselor, pediatrician, or therapist.
If this is familiar
If you're reading this and recognizing your own child in a few of these signs, you're not alone, and you didn't miss something obvious. It is difficult to discern! If you'd like support figuring out what's going on and what might help, contact me here — I'd be glad to talk it through with you.