How to Handle Anxiety in Children

Five Parts:Overcoming Anxiety with Physical TechniquesManaging Anxiety with Mental TechniquesSeeking Medical HelpUnderstanding AnxietyPreventing Recurrences

All children deal with anxiety in their lives, but not always for the same reasons. Some children may have experienced something traumatic, and others are simply more sensitive than others, and will not cope with stressful situations in the same way as their more resilient peers. Learning to deal with their anxiety will help them overcome their overwhelming fears, as well as teach them coping skills that they will most likely use for the rest of their lives.

Part 1
Overcoming Anxiety with Physical Techniques

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    Teach your child deep breathing techniques to help them relax. Deep breathing is a technique which allows children to calm themselves easily and quickly. Explain to your child that when they're anxious, they may begin breathing quicker than usual. Let them know that this may make him feel worse. Deep breathing involves taking breaths that fill the lungs and expand the tummy.[1]
    • Encourage your child to breathe in through the nose and fill their lungs. If your child is having trouble, place your hand on their stomach and show them that when they breathe, their stomach should expand.
    • Once they know how to breathe deeply, have them practice inhaling for 10 seconds, holding his breath for a moment, and then exhaling for 10 seconds. They can repeat this process as many times as they need to until they feel less anxious.
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    Teach your child muscle relaxation techniques. Muscle relaxation teaches your child how to relax his body in a way which allows your child to let go of anxiety. Have your child sit in a calm naturally lit space. Then have your child tense each group of muscles one at a time, starting with the feet and moving upwards to the neck. Then they should relax all of their muscles. If your child doesn’t understand, show them by tensing your own body.[2]
    • You can also have you child flop down on their bed, which should encourage full body relaxation.
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    Teach your child active meditation skills. Active meditation is the practice of approaching the world with intention, being present, and concentration. It is useful for both children and adults, and works by getting the practitioner to stop focusing on future or past negative experiences by focusing on the present instead. Here are some good ways to practice mindfulness for your child to implement [3]
    • Mindful listening. Take a bell, chimes, metronome, or whatever you have on hand and practice listening to it intently with your child. Focusing on something in the present will help them forget some of their anxieties.
    • Mindful seeing. Notice all the beautiful wonders of the world. See the trees, the flowers, the people going by. Simply be present in the moment.
    • Mindful eating. Take a raisin. Smell its musty aroma, feel its wrinkly texture, hear the sounds it makes when you squeeze it, and then put it in your mouth and chew slowly. Focusing on everyday, mundane things is helpful when trying to eliminate unhelpful thoughts. Make sure you keep distractions such as smartphones away when you teach your child these techniques.
    • Most of all, make sure you're having fun! If you want your child to disassociate from negative behaviors and associate with positive ones, you'll have to make the experience enjoyable.

Part 2
Managing Anxiety with Mental Techniques

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    Help your child challenge anxious thoughts. This technique is best used for older children. When children are anxious they often see the world through a veil of fearful thoughts. If you can help them reconsider the outside world and face these fears, you may make serious progress.
    • In order to address these thoughts, replace anxious thoughts with more realistic thoughts about the world. If your son is anxious about going to school, remind him that he has friends who want to play with him and that his teacher wants to tell him interesting things.
    • One statement that may help is “I’m upset now, but this feeling will go away.”
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    Don’t enable avoidance. Avoidance is a very popular coping mechanism when a person is distressed. Avoiding what upsets you may be a good short-time solution but when it comes to long-term coping, avoidance only makes problems worse. Staying away from unpleasant experiences tells your subconscious that you do have something to fear and thus only heightens anxiety levels. If your child keeps avoiding their problems instead of dealing with them, it is likely that in time the issue will deepen and will become even more difficult to handle.[4]
    • Picture this situation – your daughter gets incredibly anxious when speaking in front of the class and doesn’t want to do it. Because you feel bad and don’t want your child to suffer, you talk to the teacher and ask him to excuse her from speaking in front of the class. So, what is going to happen when your child grows up and has to talk in public but cannot get out of it? Her anxieties will most likely be even worse than they were when she was a child.
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    Help your child face their fears. Often children will avoid certain situations or places due to fear. To overcome their anxieties, they need to face these fears. However, it is best to start with something that is not as scary and work up to situations or places that cause a great amount of anxiety. To do this:
    • Start with situations that cause the least amount of anxiety and then gradually increase the intensity of the anxiety-provoking situation. Introduce your child to the situation and then allow him to use the relaxation techniques you have taught them. If your child is having trouble, walk him through relaxation steps. Once your child stops feeling so anxious, you can allow them to either leave or enjoy the situation.
    • For example, if your child is afraid of talking in front of the class, start out by having them talk just to you, then to their friends, then to their friends' parents etc. until they feel more comfortable talking in front of other people.
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    Let your child know that you accept and love them. Let your anxious child know that you love and accept them for who they are. You may think that your child already knows this, but telling him again and showing your love by hugging or spending time together is an important part of helping your child face their anxieties.[5]
    • At the same time, remember that your child is incredibly sensitive to your reactions so if you want to handle your child’s anxiety you really need to be watchful of your own behavior. Accepting your child, focusing on their positive qualities, relaxing together and teaching them or her to deal with fear is what will make a difference in reducing anxiety.
    • Accept marginalized identities. A gay child listening to parental homophobia, a girl listening to sexist parental remarks, or an autistic child hearing parents talk negatively about autism, all may feel anxious and bad about themselves. Work on getting over any prejudices for your child's mental health.

Part 3
Seeking Medical Help

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    Talk to your doctor about getting your child medication to combat the anxiety. Anxiety can become pervasive and damaging to many different aspects in your child’s life. Another way anxiety can be treated is by prescription medication. These medications can also be used with common therapeutic treatments and relaxation techniques like those listed in the previous section. You will have to work with your doctor to find the medication and dosage that will work best for your child. Medication usage can be short or long term depending on the prevalence of your child’s anxiety.[6]
    • The most commonly used anti-anxiety medication for children is the selective serotonin reuptake inhibitor (SSRI).
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    Give the doctor a complete list of other medications your child is taking. When your doctor prescribes anti-anxiety medication, it is very important that you let them know all the prescription and over-the-counter medications that your child takes.
    • Anti-anxiety medications can have interactions with other medications. This is why it is very important to let your doctor know of all the medication your child takes.
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    Create a schedule to help your child remember to take their medication. Select a time that is easy for you and your child to take the medication, and then place the meds somewhere you will remember them.[7] Try incorporating it with part of your daily routine, such as after supper or before breakfast.
    • You can create a visual schedule by hanging a calendar where your child checks off the day when they take medication. You could make it fun by having the checkmark be a sticker or some other visual aid.
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    Offer positive reinforcement to help your child feel good about taking the medication. When giving your child medication offer positive reinforcement by giving them a treat, a fun activity (e.g. half an hour of TV), or just being very positive about the process.
    • Take the medication, and then always have the treat/activity afterwards. Your child will look forward to taking the medication, because then they'll get to do the next part.
    • Another way to encourage your child to take the medication is by taking your medication at the same time (even if it’s just a multivitamin). This shows your child that taking their meds is a good thing, because their parent(s) take their medication with them.
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    Avoid negativity about meds. Whatever method you choose to help integrate taking medication into your child’s life should be successful unless you are negative. Negativity about taking medication will only further serve to cause stress for your anxious child.
    • If you have a medication concern, talk about it with a spouse or doctor, when you're sure your child is out of earshot. Let out your fears when your child can't hear and obsess over them. Then, if it's necessary to talk to your child, you can do it in a reassuring way.
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    Understand that there are some side effects that can come with taking anti-anxiety pills. It’s important to know that the FDA recently issued a warning with SSRIs. In a small number of children, SSRI’s may increase suicidal thoughts and behaviors.[8] This risk is very small, but it will be important to monitor your child’s behavior when they begin taking anti-anxiety medication.
    • Discern between suicidal thoughts that are new, and ones that were already there. If your child brings them up to you, ask how long they've felt this way. (Now that the problem is identified, your child may start being more open about their symptoms, instead of keeping them quiet.) Be cautious and mindful when determining whether medication caused it.
    • Your child may also suffer from mild side effects like headache, nausea, and difficulty sleeping.

Part 4
Understanding Anxiety

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    Recognize the nature of anxiety. Anxiety has three parts: physical symptoms, mental symptoms, and behavioral symptoms. Some children may only show one of the symptoms of anxiety, such as feeling fear in response to social interaction, but without necessarily knowing it is fear or associating it with their situation. Other children may show all of them, such as feeling the fear, understanding it as fear, and then avoiding the situation.
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    Understand the causes of anxiety. Your child may fear strangers, separation, monsters, or injury, but you can't address these fears unless you know why. Perhaps your child does not feel completely safe and secure, and so believes you will abandon them permanently when you leave. Perhaps your child does not like their social peers, or is afraid of them, and so cannot interact properly. Whatever the reasons, make sure you understand them before you proceed.
    • Ask questions like "Why do you feel that way?" and "What makes you think that?" Use a calm, understanding tone to show that you are ready to listen without judging.
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    Learn the progression of childhood anxiety. Not all children fear the same things at the same time. Some may fear social interaction, others strangers, and others separation from their parents. Here is a list of common anxieties sorted by age:
    • At infancy, children experience a fear of strangers and exhibit clinging behavior with their parents.
    • In toddlerhood, children experience separation anxiety when one or both parents leave them.
    • In early childhood, children begin to experience more abstract fears, such as of the dark, monsters under their bed, and strange sounds in the night.
    • Towards adolescence, children start to understand the nature of the world, and begin to fear pain, bodily injury, disasters, crime, etc.
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    Realize that some anxiety is normal. The world is a scary place, and as adults know but sometimes do not realize, it gets scarier the older you become. War, crime, racism, sexism, and other social ills are terrible and, thankfully, beyond the understanding of most young children. Their anxieties are for less dangerous things, like social interaction or strangers, which is often normal depending on age. However, if those anxieties become excessive, they may grow as your child ages, when more pressing concerns become a reality. Remember also that, regardless of age, some forms of anxiety are always normal.
    • Meeting new people is a source of anxiety even for adults, and as long as it is not overwhelming, it is generally not problematic.
    • Starting something new, such as school, is often difficult. Just ask adults about to start a new job!
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    Realize that excessive anxiety is not normal. The world is scary, sure, but plenty of people go through it every day and come out fine. You need to make sure your child understands that fear is healthy and protective, like when a child is afraid of fire because it hurts if they touch it. However, your child also needs to know that they do not need to be afraid of some things in the same way, like visiting the doctor or going for a playdate. The key is a healthy balance, and anxiety becomes a problem when:
    • Anxiety causes significant emotional or physical distress in everyday life, such as when a child's separation anxiety is so severe that he or she cannot attend school because the parent has left.
    • Anxiety becomes serious when it interferes with daily life. If your child keeps waking you up at night, fakes sick to avoid certain events, wants to make friends but is too scared, or misses classes due to stress stomachaches, these are all example of anxiety that interferes with life and needs treatment.

Part 5
Preventing Recurrences

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    Take the time to research and learn about anxiety in children. If you have observed some anxious behavior in your child, it is now time to educate yourself about childhood anxiety to get to the root of the issue. Realize that anxiety is normal, and everyone (including children) experiences anxiety at some point in their life. Anxiety can be adaptive, and at times helps people deal with dangerous situations or perform at their best. Anxiety only becomes problematic when the body reacts anxiously in the absence of danger or a stressful situation. To learn more about anxiety:
    • Talk to a doctor or therapist and ask questions regarding your child’s condition.
    • Run internet searches through legitimate medical websites like the National Institute of Health.
    • Read articles and books about anxieties.
    • Read some personal essays from people who experience(d) anxiety disorders.
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    Observe your child's symptoms. If you suspect something is wrong with your child, you need to first observe whether his or her behavior, physical state, or thoughts are indicative of anxiety. A few things to look for:
    • Clingy behavior, such as crying or temper tantrums when you leave your child.
    • Excessive shyness, such as avoiding contact with others or running away from social situations.
    • Seeming to be overly worried about things.
    • Being driven by fear to avoid people, places, or things
    • Panic attacks in response to stimuli.
    • Physical symptoms, such as minor pains like stomachaches or headaches.
    • Persistent worries, that don't go away after logical explanations (e.g. "We don't get tornadoes often, and if we do, we have a safe basement") and reassurance.
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    Talk to your child about the physical symptoms they may be experiencing. Your child may be feeling a sinking feeling in their stomach, or be suffering from headaches or stomachaches, or any number of physical ailments. However, they may not understand that this is connected with anxiety. If you suspect your child is suffering from anxiety, make time to talk with them frankly, openly, and safely about it. Get them to describe in detail what they are feeling, where, and in response to what. If your child describes feeling any of the following, they may be suffering from anxiety:
    • Rapid heart rate.
    • Rapid breathing.
    • Stomach pain or nausea.
    • Feeling hot or cold.
    • Sweating, shaking, and dizziness.
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    Discuss your child’s mental blocks. Physical problems may be medical conditions separate from anxiety, and so if your child experiences stomachaches, that may be a function of their bowels rather than their anxiety. Try to pin down whether these physical states have a mental origin. Young children may not be able to identify any anxious thoughts even when they are very anxious, so continue asking thoughtful questions while maintaining a safe and open space. Try to piece together where your child has felt anxious, and then ask about what might have triggered those feelings. Some anxious thoughts might include:
    • What if I fall off my bike and everyone laughs?
    • What if my house starts on fire?
    • What if Mom doesn’t come to pick me up after school?
    • What if other kids don’t like me?
    • What if I make lots of mistakes on my spelling test?
    • What if Dad doesn't love me and thinks I'm annoying?
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    Look for behaviors that demonstrate your child’s anxiety. The most common types of behaviors exhibited by children with anxiety are avoidance and reassurance seeking. In a situation of threat or perceived threat the child will avoid what they fear. While this is fine if there is a real threat, in daily life this could prevent children from coping with challenging situations.[9] Many children may avoid anxiety provoking situations such as:
    • Not wanting to eat in the cafeteria.
    • Not wanting to go swimming.
    • Not wanting to got to preschool or school.
    • Not wanting to raise their hand in class.
    • Not wanting to sleep in their own room.


  • Make a routine for meals, homework, quiet time, and bedtime if your child seems stressed by changes in routine.
  • Work together with your partner or other adults in the household to manage your child’s anxiety.
  • Give consequences for rule-breaking. Anxiety does not give your child a green light to misbehave. Set limits and expectations for your child and follow through with consequences.
  • Be supportive while your child is facing their fears. Also be sure not to minimize his or her fears by telling him or her that he or she is being silly or stupid.
  • Build self-confidence by involving your child in activities that make him or her proud.
  • Remember to manage your own reactions. In order to do this you must care for yourself by eating well, sleeping, and exercising.
  • Take risks with your anxious child by trying new things and exposing them to new situations and surroundings.


  • If your child is taking an SSRI and begins to display suicidal thoughts or behaviors, go to your doctor right away.

Sources and Citations

  1. Essau, C., Petermann, F., Anxiety Disorders in Children and Adolescents. 2013
  2. Miller, S. M., Boyer, B. A., & Rodoletz, M. (1990). Anxiety in children. InHandbook of developmental psychopathology (pp. 191-207). Springer US.
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Article Info

Categories: Stress Anxiety and Crisis Management | Childhood Fears and Phobias