A Black child looks out a schoolbus window with a worried expression.

Anxiety: When to Get Support

Anxiety can show up in children’s thoughts, emotions, behavior, or as physical symptoms – and it’s not always what adults expect. The list below shares some of different symptoms that families may see.

Note: This list is not meant to be comprehensive, nor should it take the place of diagnosis from a qualified professional. It is intended as a starting point for families to use in a conversation with your provider.

Needing Excessive Reassurance

Some children with anxiety need a lot more reassurance than their peers. These children may ask lots of “what if” questions or struggle with logical arguments.

Needing Things to Be Perfect

Children may try to shield themselves from anxiety by setting high standards. These children may be self-critical or try to make everything perfect.

Some children who look anxious may also lean toward perfectionism because they are gifted.

Easily Upset or Angered

Children who are easily upset, angered or who need a lot of coaxing to deal with ordinary situations may be struggling with anxiety. Common examples include completing homework, hygiene activities, mealtimes, etc.

Some children who look like they are anxious may also be easily upset because they have sensory differences. Children with executive function (EF) challenges can also have emotional outbursts due to poor flexibility and inhibition control.

Having Big Reactions or "Chandeliering"

Big reactions that don’t fit the situation, like crying, anger, hitting/throwing or tantrums may be a sign of anxiety. Social scientist, Brené Brown, has called this behavior “chandeliering,” because a small thing seems to send the person straight to the chandelier.

All children can have behavior problems (like tantrums) from time to time. Children with autism or with EF challenges can also have big reactions because they often struggle with flexibility.

Excessive Avoidance or Defiance

When children refuse to participate in expected activities, like school, religious services or family vacations, it may be a sign of anxiety.

Some children may also avoid school because they are struggling to learn. Children with learning disabilities, like dyslexia, dyscalculia and dysgraphia, may avoid subjects where their disability makes learning more difficult.

People Pleasing

“Fawning” is a reaction to stress that some people use instead of fight/flight/freeze. Children who are excessive people-pleasers may worry that others are upset with them, apologize unnecessarily, or be overly responsible compared to other children their age.

Sleep Disruption

Children with anxiety often experience sleep disruption, including troubles falling asleep, nightmares and difficulty sleeping alone. This can also look like excessive avoidance during bedtime routines.

Some neurodivergent children, including kids with ADHD or autism, may also struggle with sleep disruption.

Frequent Aches and Pains

Children with anxiety may experience headaches, stomachaches or other physical symptoms that keep them out of school. Families should always check with a primary care provider first when a child experiences aches and pains that are out of the ordinary.

Related Diagnoses

In addition to the symptoms listed here, some children may experience anxiety along with another diagnosis. It is estimated that roughly 60% of people with anxiety also have symptoms of depression. Anxiety also co-occurs frequently in people with autism or ADHD. A meta-analysis that looked at 31 different studies found that about 4 in 10 young people with autism had at least one co-occuring anxiety disorder. About 1 in 4 to 1 in 2 children with ADHD also have anxiety disorders.

Back to Anxiety Guide.