Ask Dr. Steve: When worry takes over: Understanding childhood anxiety

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Steven A. SzykulaThe children in our care today seem to carry heavier emotional burdens than previous generations. While childhood has always included worries and fears, the scale and intensity of anxiety we’re seeing now is unprecedented. Understanding these challenges isn’t about creating alarm or dwelling on problems–it’s about recognizing what our young people are facing so we can better support their emotional well-being.
Remember, recognizing these challenges isn’t about blaming anyone or anything. It’s about understanding how modern stressors uniquely affect developing minds so we can guide young people toward healthier coping strategies and emotional regulation skills.
Q: Why does my child seem so much more anxious than the kids I grew up with?
A: Today’s children face several unique stressors that previous generations didn’t experience. They’re exposed to unfiltered global information through 24-hour news cycles, social media comparisons, and less unstructured play time to naturally work through worries. Additionally, well-meaning parents often remove obstacles from children’s paths, which prevents them from learning that they can handle difficult situations.
Q: How do I know if my child’s worry is normal or something to be concerned about?
A: Clinical anxiety affects about 1 in 8 children today. Normal worry is temporary and specific to a situation, while anxiety tends to be persistent and interferes with daily functioning. Look for physical symptoms like frequent stomach aches or sleep problems, avoidance of age-appropriate activities, or worry that seems disproportionate to the situation. If anxiety is limiting your child’s life or causing significant distress, it’s worth seeking professional guidance.
Q: Why is my young child complaining of stomach aches when nothing seems to be wrong physically?
A: Children under 10 often express anxiety through physical complaints, particularly stomach aches and sleep disturbances, because they don’t yet have the vocabulary to describe emotional states. Their bodies are responding to stress, but they can’t identify it as anxiety. This is completely normal and doesn’t mean they’re making it up–their distress is real, even if the cause is emotional rather than physical.
Q: At what age do children start to worry about abstract things they can’t control?
A: Children typically develop the cognitive capacity for abstract worry around 8-10 years old. This explains why exposure to adult social media platforms and news at this age can be particularly problematic — they can understand enough to worry about global events or social situations, but they don’t yet have the coping skills to process these concerns appropriately.
Q: Why does my child need constant reassurance about everything?
A: If your child’s world feels unpredictable or overwhelming, their nervous system learns to stay alert for danger. Seeking reassurance is their way of trying to feel safe. This makes complete sense from their perspective–they’re trying to gather information to determine if they’re okay. The challenge is that too much reassurance can actually increase anxiety over time by confirming that there’s something to worry about.
Q: How can I provide comfort without feeding my child’s anxiety?
A: Instead of immediately reassuring them that everything will be fine, try reflecting their feelings first: “You’re really worried about this.” Then help them problem-solve: “What do you think you could do if that happened?” This validates their experience while building their confidence in handling uncertainty. Sometimes the most helpful thing you can do is sit with their discomfort rather than trying to fix it immediately.
Q: Why does my child avoid activities they used to enjoy?
A: Avoidance is anxiety’s main strategy for feeling safe. If your child has had a negative experience or even imagined one, their brain might decide that avoiding the situation entirely is the safest option. While this reduces anxiety in the short term, it actually strengthens it over time because they never learn that they can handle the situation.
Q: How do I help my child face their fears without forcing them?
A: The key is gradual exposure combined with support. Start with very small steps toward the feared situation and celebrate each small success. For example, if they’re afraid of dogs, start by looking at pictures of dogs, then watching dogs from a distance, then maybe petting a very calm dog. Let them set the pace while encouraging small steps forward.
Q: Which part of the brain is most affected by chronic anxiety in children?
A: The amygdala, which processes fear and threat detection, shows the most significant changes in children with chronic anxiety. It becomes enlarged and hyperactive, leading to heightened fear responses and difficulty distinguishing between real and imagined threats. This is why anxious children often react strongly to situations that seem minor to adults.
Q: What happens if childhood anxiety isn’t addressed?
A: Research shows that 60-70% of children with untreated anxiety disorders develop secondary depression by adolescence. Early intervention is crucial because anxiety patterns can become deeply ingrained over time. However, evidence-based treatments like cognitive-behavioral therapy are highly effective, especially when started early. The goal isn’t to eliminate all worry — it’s to help children develop healthy coping strategies.
Q: How long does effective anxiety treatment usually take?
A: Evidence-based treatments like cognitive-behavioral therapy show optimal effectiveness with 12-16 weeks of intervention. This duration allows sufficient time for children to learn new skills and for their brains to develop new neural pathways. Shorter interventions may provide some relief, but longer treatment periods typically lead to more lasting change.
Q: How can I tell if my child’s anxiety is related to school or social pressures?
A: School-related anxiety often shows up as physical complaints on school mornings, reluctance to attend, or meltdowns around homework time. Social anxiety might manifest as avoiding playdates, not wanting to speak up in class, or seeming different after social interactions. Pay attention to when symptoms are worse–if they improve dramatically on weekends or school breaks, environmental factors are likely contributing significantly.
Q: What role does social media play in childhood anxiety?
A: Social media exposes children to constant comparison with others, cyberbullying, and information their brains aren’t ready to process. Children as young as 8 are accessing platforms designed for adults, leading to exposure to unrealistic standards and social dynamics they can’t yet understand. The fear of missing out (FOMO) and pressure to maintain an online image can create persistent low-level stress.
Q: How can I build my child’s resilience without making them tough?
A: Resilience comes from experiencing manageable challenges with support, not from toughening up. Let your child struggle a bit with age-appropriate problems while staying emotionally available. Teach them that feelings are temporary and manageable. Help them identify their strengths and past successes. The goal is helping them trust that they can handle difficult situations, not that they have to handle them alone.
Q: When should I seek professional help for my child’s anxiety?
A: Consider professional help if anxiety interferes with your child’s daily functioning for more than a few weeks, if they’re avoiding important activities like school or friendships, if physical symptoms persist despite medical evaluation, or if your family life is significantly disrupted. Trust your instincts–if you’re concerned, it’s worth having a professional assessment.
Closing
The anxiety challenges facing today’s children are real and significant, but they’re also highly treatable when recognized and addressed appropriately. Understanding that childhood anxiety often stems from environmental and social factors rather than personal failings helps us respond with compassion rather than frustration. These aren’t character flaws in our young people; they’re predictable responses to genuinely overwhelming circumstances.
The good news is that anxiety is one of the most successfully treated mental health conditions in children. Small, consistent changes in how we support anxious children can lead to significant improvements in their emotional regulation and overall well-being. Whether it’s teaching coping strategies, creating calmer environments, or seeking professional support, every step toward understanding and addressing anxiety matters.
Remember that building emotional resilience is a gradual process. Start with small changes that feel manageable for your family, and build from there. Celebrate your child’s brave moments–every time they face a fear or try a new coping strategy, they’re building stronger neural pathways for managing anxiety. Be patient with setbacks, and remember that seeking help from professionals is often the most loving thing you can do.
Your child’s anxiety makes sense given their world, and with understanding, evidence-based strategies, and patience, they can learn to manage their worries and develop the emotional tools they need to thrive. The care and concern you’re showing by learning about anxiety is already an important step in supporting their emotional development.
This article is authored by Jason Sadora, MS, and Steven Szykula, Ph.D.