Anxiety in children

Alternative names 
Fear in children; Stress in childhood; Childhood stress

Childhood stress can be caused by any situation that requires adaptation or change. Such situations often produce anxiety. Stress may be evoked by positive changes such as starting a new activity, but it is most commonly linked with negative changes such as illness or death in the family.


Stress is a response to any situation or factor that creates a negative emotional or physical change or combination of both emotional and physical changes (the most typical scenario). Stress is an unavoidable aspect of life. People of all ages can experience stress. Some stress is helpful because it provides motivation. However, excessive stress can interfere with life, activities, and health.

Previous experience, education, and support enable most people to respond appropriately and to change as circumstances require. Response to stress is both learned and natural and may be appropriate and healthy, or it may be inappropriate and unhealthy. Stress can affect the way people think, act, and feel.

All people have natural responses to stress (such as increased vigilance, aggressiveness, blocking out pain) that allow them to survive while the body recognizes and responds to severe stresses. Children learn to respond to stress by personal experience and by observation. Most stresses experienced by children may seem insignificant to adults, but because children have few previous experiences from which to learn, even situations that require small changes can have enormous impacts on a child’s feelings of safety and security.

Pain, injury, and illness are major stressors for children. Medical treatments produce even greater stress. Recognition of parental stress (such as that seen in divorce or financial crisis) is a severe stressor for children, as is death or loss of a loved one.

Children may not recognize that they are stressed. Parents may suspect that the child is excessively stressed if the child has experienced a potentially stressful situation and begins to have symptoms such as:

  • Physical symptoms       o headache       o upset stomach or vague stomach pain       o sleep disturbances       o nightmares       o new or recurrent bedwetting       o decreased appetite, other changes in eating habits       o stuttering       o other physical symptoms with no physical illness  
  • Emotional or behavioral symptoms       o anxiety       o worries       o inability to relax       o new or recurring fears (fear of the dark, fear of being alone, fear of strangers)       o clinging, unwilling to let you out of sight       o questioning (may or may not ask questions)       o anger       o crying       o whining       o inability to control emotions       o aggressive behavior       o stubborn behavior       o regression to behaviors that are typical of an earlier developmental stage       o unwillingness to participate in family or school activities

Parents can help children respond to stress in healthy ways. Some things parents can do include the following:

  • Provide a safe, secure, familiar, consistent, and dependable home.  
  • Be selective in the television programs that young children watch (including news broadcasts), which can produce fears and anxiety.  
  • Spend calm, relaxed time with your children.  
  • Encourage questions.  
  • Encourage expression of concerns, worries, or fears.  
  • Listen to your child without being critical.  
  • Build your child’s feelings of self-worth. Use encouragement and affection. Try to involve your child in situations where he or she can succeed.  
  • Try to use positive encouragement and reward instead of punishment  
  • Allow the child opportunities to make choices and have some control in his or her life. This is particularly important, because research shows that the more people feel they have control over a situation, the better their response to stress will be.  
  • Encourage physical activity.  
  • Develop awareness of situations and events that are stressful for children. These include new experiences, fear of unpredictable outcomes, unpleasant sensations, unmet needs or desires, and loss.  
  • Recognize signs of unresolved stress in your child.  
  • Keep your child informed of necessary and anticipated changes such as changes in jobs or moving  
  • Seek professional help or advice when signs of stress do not decrease or disappear.

Children can do some things for themselves to help reduce stress. Tips include the following:

  • Talk about your problems. If you cannot communicate with your parents, try someone else that you can trust.  
  • Try to relax. Listen to calm music. Take a warm bath. Close your eyes and take slow deep breaths. Take some time for yourself. If you have a hobby or favorite activity, give yourself time to enjoy it.  
  • Exercise. Physical activity reduces stress.  
  • Set realistic expectations. Do your best, and remember that nobody is perfect.  
  • Learn to love yourself and respect yourself. Respect others. Be with people who accept and respect you.  
  • Remember that drugs and alcohol NEVER solve problems.  
  • Ask for help if you are having problems with stress management.


Johns Hopkins patient information

Last revised: December 8, 2012
by Brenda A. Kuper, M.D.

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