Anxiety in young children

We've been hearing more and more about anxiety, notably in young children. How do kids express their anxiety, and what can be done to help them overcome it?

Continue

Understanding anxiety

It’s normal for a young child to feel anxious when faced with a new situation. But what makes some children more anxious than others?

By Julie Leduc

It’s normal for a young child to feel anxious when faced with a new situation. But what makes some children more anxious than others?

Anxiety is a normal emotion we sometimes feel in the face of perceived danger. “It’s an exaggerated fear response,” explains psychoeducator Suzie Chiasson-Renaud. “The threat doesn’t have to be real; the person simply has to feel threatened. That’s why anxiety is sometimes triggered by our own thoughts, because we’re imagining the worst-case scenario.”

For example, if a child starts crying because a large dog suddenly barks at them, that’s a normal fear response. If a child is scared to go to the park because there might be dogs there, that’s an exaggerated response due to anxiety. If a child is afraid of dogs because they were once bitten by one, however, their fear is a normal reaction. They can learn to overcome it with their parents’ help.

Fears and worries are all part of a child’s development. Anxiety serves a protective function by helping kids err on the side of caution in new situations. “Occasional anxiety in young children is perfectly normal,” says Chiasson-Renaud. “They’re exposed to so many new situations and unknowns. In addition, they don’t know how to self-regulate yet because their brains are still maturing, and they can’t always tell the difference between real and imaginary. That’s why feelings of anxiety can be more frequent and more intense during early childhood.”

As children get older and adapt to new situations, their anxiety generally dissipates. Of course, a child will periodically deal with varying levels of anxiety throughout their life based on their temperament and experiences (e.g., the first day of school or summer camp). How parents respond to their child’s anxiety can also have an impact. An anxious parent may cause their child to become more anxious. For this reason, it’s important for parents to seek help if they have trouble managing their own anxiety.

What causes anxiety?

All children can experience anxiety, but some are more anxious by nature. Below are the main factors that explain why one child might be more anxious than another.

  • Temperament. A shy, fearful child may be more prone to anxiety.
  • Genetics. “Very often, a child who shows signs of anxiety has at least one anxious parent,” says psychologist Dr. Tina Montreuil, an associate professor at McGill University, where she is also director of the Childhood Anxiety and Regulation of Emotions (C.A.R.E.) Research Group and a researcher at the Research Institute of the MUHC. Genetics play a role, but anxiety can also be passed down to a child through a parent’s actions, such as worrying too much or being overprotective.
  • Overprotective parents. A parent who’s always worried something will happen to their child, or who has a hard time being away from them or leaving them with someone else, can end up making their child anxious. Being overprotective can hurt your child’s self-confidence and make them anxious about the future and things they can’t control.
  • Major life changes, such as the birth of a new sibling or parental separation. These types of events can put parents under more stress, causing them to be less available for their child. For example, 4-year-old Marion started showing signs of anxiety after her little brother, Arnaud, was born. “Arnaud was hospitalized twice while he was still a newborn, so we often had to leave Marion with a babysitter,” says their dad, Carl Ducharme. “She started getting anxious whenever she wasn’t with us, at daycare and in the middle of the night.”
  • A lack of routines and rules. Children need clear, concrete rules to feel safe. Otherwise, they don’t know what to expect, which can create anxiety.
  • A hectic family schedule. When young children don’t have enough quality time with their parents, they can become anxious. These bonding moments make them feel safe, calm, reassured, and emotionally balanced.
  • High parental expectations. Children can become anxious if they’re afraid of making mistakes and disappointing their parents.
  • Trauma. For instance, a child who’s rushed to the hospital for multiple treatments may feel anxious about getting shots or develop anxiety around needles. The same thing can happen after an episode of anaphylactic shock.
  • Volatile parents or loved ones. A child can become insecure and anxious if they grow up with parents who fight a lot, or the constant arguing can simply worsen their anxiety. A parent or loved one who is prone to angry outbursts can have the same effect.

How do I know if my child is anxious?

“When my son is feeling anxious, he becomes a real fireball,” says Jolianne Korak. Her son, Alexis, is 3 and a half. “He has so much energy to burn. He’ll sometimes run down the street, yell, throw things, or hit me.”

Since small children don’t have the words to express how they’re feeling, their anxiety manifests through their behaviour. Some, like Alexis, become agitated and aggressive. Temper tantrums, crying, confrontational behaviour, and irritability are other potential signs of anxiety.

“Anxiety is sometimes mistaken for hyperactivity, because anxious children can have difficulty controlling themselves,” says Dr. Montreuil. “For example, they might have trouble sitting still or behave aggressively during recess.”

Dr. Montreuil notes that there is also the other end of the spectrum. “When a shy child gets anxious, they may show no outward signs of it at all.” They might freeze up, fall silent, avoid other people, and show no emotion when they’re with strangers or in public. Six-year-old Elyam is one such child. “In new situations, he gets overwhelmed and won’t move for several minutes,” says his mother, Mira Dana.

Stomachaches, headaches, and nausea are other signs of anxiety in young children. “Anxious kids also tend to have sleep problems,” says Marie-Ève Mongrain, a psychoeducator at the Vaudreuil-Dorion CLSC. “They can’t sleep without their parents, have trouble falling asleep, and wake up during the night.” For about a year, that’s exactly what Marion’s parents went through. “Almost every night, she’d wake up to check that we hadn’t gone back to the hospital,” her dad recalls.

Helping an anxious child

Fortunately, there are many ways to ease your child’s anxiety. It’s a good idea to act early, before their fears and worries have a chance to grow.

Fortunately, there are many ways to ease your child’s anxiety. It’s a good idea to act early, before their fears and worries have a chance to grow.

Maintaining a kind, calm, reassuring, and consistent demeanour with your child helps them feel safe and reduces their anxiety.

Other ways to help your child when they’re anxious

  • Give them transitional objects to comfort them when they’re away from you. “Marion used to cry a lot when I dropped her off at daycare, so I started tying her hair with a special bow every day,” says her mom, Marie-Pier Clément. “I wore an identical bow and told Marion that it made me think of her all day long. We also left family photos at her daycare. Marion could look at them whenever she was feeling anxious. At bedtime, I would give her an item of my clothing. If she woke up in the night, she could snuggle it and feel like I was with her.” Indeed, it can help to leave your child an object, like a blanket or sweater, that smells like home or one of their parents.
  • Establish a routine. Knowing how the day will unfold is reassuring for a young child. Marion’s dad, Carl, has seen this first-hand: “When we come home, we have a snack, talk about our day, and play together. I make time for Marion, and she enjoys our routine.” In these moments, Marion is also learning to express her feelings, whether positive or negative. When children share their emotions instead of bottling them up, they feel less anxious.
How common is anxiety in early childhood?
It’s difficult to measure exactly how many young children are affected by anxiety. “Kids under the age of 5 don’t have a lot of words to express how they’re feeling,” says psychoeducator Suzie Chiasson-Renaud. What’s more, the numbers vary from one study to another.
According to the DSM-5, the key criterion for diagnosing generalized anxiety disorder in children is significant distress that affects multiple areas of their life (activities, sleep, diet, social life) and that persists for at least six months. When it comes to separation anxiety disorder, distress must be present for at least four weeks.
The specialists we interviewed for this feature noted a high demand for services to support children dealing with anxiety, though not necessarily anxiety disorders. A family’s lifestyle can be overwhelming for young children, increasing their stress and anxiety. “In many households, both parents have jobs, so their kids spend a lot of time at daycare,” says psychoeducator Marie-Ève Mongrain. “The whole family has a packed schedule.”
Other aspects of modern life can also affect anxiety levels, such as parental separation, which can upend a young child’s routine (moving house, no longer seeing certain relatives, becoming part of a blended family, etc.), and excessive screen time.
Keep in mind that a certain level of anxiety is normal in children. “Don’t panic if your little one is experiencing anxiety,” says Dr. Tina Montreuil, a psychologist. “The important thing is to be aware so that you can help them overcome their fears and manage their emotions.”
  • Stay calm. “Children with anxiety experience very intense emotions,” says Dr. Montreuil. “They often cry or have tantrums because what’s happening inside their body is confusing and scary. If their parents get upset, that only compounds their fear.” That’s why it’s best to try to keep calm. This shows your child that whatever they’re worried about doesn’t scare you, and that it’s okay if they’re anxious,” says Dr. Montreuil. You can then tell them, “I’m right here. I know you’re upset and probably feeling a little scared. Those feelings are perfectly normal, and they won’t last forever.”
  • Help them verbalize their emotions. For example, you can say, “I can feel that your heart is beating really fast.” Ask questions to find out what’s bothering your child or triggering their anxiety. When you help your child put their emotions into words, they feel understood, which can help calm them down. Physical contact, like a kiss or a hug, is another effective way to comfort your child.
  • Follow their lead. Don’t rush your child; give them enough time to overcome their fears and adapt to the situation. “Elyam gets really shy whenever we go somewhere new,” says his mother, Mira Dana. “We don’t pressure him. We let him take his time getting comfortable in his new surroundings.”
  • Help them gradually face their fears. It’s also important not to avoid situations that make your child anxious. This can actually prevent them from overcoming their anxiety, or even make it worse. Instead, we recommend gradually exposing them to their fears while making sure they always feel supported and in control. Eventually, they’ll feel capable of facing these scary situations alone. “If your child is afraid of dogs, you can start by reading them books about dogs,” suggests psychoeducator Suzie Chiasson-Renaud. “Then you can watch a movie about a dog, followed by going to the dog park. Start by observing from a safe distance, and then slowly encourage your child to get closer.” It’s essential to respect your child’s boundaries and not to rush them.
  • If possible, simplify your schedule. Slow down, de-stress, and spend more time with your family. All of these actions will help ease your child’s anxiety.
  • Teach your child breathing exercises. When your child is calm, try teaching them a breathing exercise by turning it into a game. For example, tell them to place their hands on their belly and pretend they’re inflating a balloon as they inhale, then letting out all the air as they exhale.
  • Make sure your child is doing enough physical activity every day. Running, jumping, dancing, singing, and laughing are all excellent ways for your child to get rid of tension and anxiety.
  • Congratulate your little one when they manage to face their fears. The next time they’re feeling anxious, remind them of a situation where they battled through their anxiety.
When should you consult a doctor?
If you or your child needs help managing anxiety, contact one of the following support services:
  • Your local CLSC
  • Info-Social (811)
  • Première Ressource, aide aux parents (1-866-329-4223)
  • Your workplace employee assistance program, if applicable
However, if your child’s anxiety is interfering with their daily life and not improving despite your best efforts, we recommend consulting an early childhood specialist (e.g., pediatrician, child psychologist, psychoeducator, social worker). You should also take them for a checkup to rule out physical health issues, such as hypoglycemia or a hormonal imbalance.

What to avoid

Don’t be overprotective. Doing everything for your child, or shielding them from new experiences because they might get hurt or make a mistake, will only fuel their anxiety. They’ll start to think the world is dangerous and that they need you to protect them.

It’s also important not to avoid situations that make your child anxious. According to Dr. Montreuil, parents need to accept that their child will sometimes experience negative emotions. Show them you understand how they feel and help them gradually overcome their fears.

Life experiences help kids develop a certain resistance to anxiety,” says Dr. Montreuil. “For example, they eventually learn that they can feel okay even when their parents aren’t around.” They become more confident and independent, which in turn decreases their anxiety. Encouraging children to build relationships with their friends, grandparents, aunts and uncles, neighbours, and so on helps them learn to trust people outside their own home.

Don’t neglect your own anxiety

Anxiety is contagious: If you’re an anxious person, your emotions will affect your child. “As soon as I get anxious, my son starts to act out,” says Jolianne Korak. “When that happens, I leave the room and take a few deep breaths. I try to focus on the present instead of worrying about the future.” According to Dr. Montreuil, it’s crucial for parents to manage their anxiety. “They need to find coping strategies,” she says. “If they can’t do it on their own, they should consider speaking with a professional. Parents need to take care of themselves before they can take care of their children.”

Things to keep in mind
  • It’s normal for young children to get anxious from time to time.
  • Some children are more anxious by nature, whether because of their temperament, genetics, or family environment.
  • Toddlers lack the words to say what they feel, so their anxiety manifests in their behaviour (anger, tears, aggression, opposition, sleep problems) and in their bodies (restlessness, hyperactivity).
  • You can help reduce your child’s anxiety by maintaining a calm, reassuring attitude and managing your own anxiety.
Naître et grandir

Source: Naître et grandir magazine, September 2019
Research and copywriting: Julie Leduc
Scientific review: Nathalie Parent, psychologist, author, and training instructor
Updated: September 2024

Photos: Maxim Morin, GettyImages/Fatcamera, nd3000, and romrodinka

RESOURCES

For parents

Couture, Nathalie, and Geneviève Marcotte. Incroyable Moi maîtrise son anxiété (new edition). Éditions Midi trente, 2021, 48 pp.

Doyon, Nancy, and Suzie Chiasson-Renaud. Pleurs, crises et opposition chez les tout-petits … et si c’était de l’anxiété? Éditions Midi trente, 2018, 192 pp.

Hébert, Ariane. Anxiété, la boîte à outils (revised and expanded edition). Éditions de Mortagne, 2023, 208 pp.

Leroux, Sophie. Aider l’enfant anxieux. Éditions du CHU Sainte-Justine, 2016, 168 pp.

Leroux, Sophie. L’anxiété chez l’enfant et l’adolescent. Éditions du CHU Sainte-Justine, 2022, 228 pp.

Pelletier, Geneviève. Les peurs et l’anxiété chez l’enfant. Broquet, 2019, 168 pp.

For kids

Latulippe, Martine, and Nathalie Parent. L’anxiété de Timothée. Saint-Jean Éditeur, 2022, 28 pp.

Latulippe, Martine, and Nathalie Parent. La peur de Mathis. Saint-Jean Éditeur, 2020, 28 pp.

Snel, Eline. Sitting Still Like a Frog Activity Book: 75 Mindfulness Games for Kids. Bala Kids, 2019, 93 pp.

Watt, Melanie. Scaredy Squirrel. Kids Can Press, 2006, 40 pp.