Childhood Anxiety is Not Always What You Might Think

By Zara Teichrow, LMSW

Meltdowns, tantrums, defiance, or aggressive behavior can mask underlying feelings of anxiety. Typically when we see a child being defiant at home or school, our first thought might be, “that child is angry” and “they don’t like to follow rules.” Or we might say “that child is disrespectful.” But, underneath that anger or tantrum, are often feelings of overwhelming anxiety or worry.

Is that tantrum really a symptom of anxiety?

When we think about an anxious child, what are usually the first things that come to mind? We might picture a child who is shy, one who clings to adults, freezes up, or is scared of many things. We might think of the kiddos with childhood anxiety as those who struggle to go to sleep at night without their parents by their bed, or those who get nervous to make new friends.

While all of these things can be true, contrary to common belief, childhood anxiety disorders can also appear in the form of challenging or disruptive behavior. Meltdowns, tantrums, defiance, or aggressive behavior can mask underlying feelings of anxiety. Typically when we see a child being defiant at home or school, our first thought might be, “that child is angry” and “they don’t like to follow rules.” Or we might say “that child is disrespectful.” But, underneath that anger or tantrum, are often feelings of overwhelming anxiety or worry.

These types of negative behaviors may be a sign that your child is anxious. And it’s entirely possible that neither you or your child may even be aware of it. Anxiety can be sneaky and wear different masks, one of them being behavioral concerns. Parents or teachers may often mistake an anxious child as simply being disobedient or defiant. This is because many children struggle to talk about how they feel. They may also not know how to cope with their anxiety in a healthy way. Noticing and correctly identifying the signs can be difficult or confusing for anyone.

What does childhood anxiety look like?

The National Institute of Mental Health estimates that one in eight children in the United States suffers from an anxiety disorder. Childhood anxiety is the most common mental health concern for children. Feeling worried, nervous, or anxious at times is a normal part of childhood. A kindergartener starting his first day of school might cling to his mom at drop off time. Another child might beg her dad to stay in the room with her until she falls asleep for fear of monsters under the bed. Older children might worry about fitting in with peers or succeeding in academics or sports.

Anxiety is a natural reaction to stress or a perceived threat, and can actually be helpful. If we never felt worried or hesitant about anything, we might find ourselves unprepared for stressful situations or not paying attention when there is danger around us. However, anxiety can become a problem when it becomes excessive and interferes with a child’s daily life and functioning. With an anxious child, you may begin to notice a pattern of changes at school, home, or with friends. But, it can be subtle and may look different with each kiddo.

Here are some generally common and expected signs that your child might be experiencing anxiety:

  • Difficulty sleeping. Racing thoughts may keep kids up at night. They may also be worried that they will miss their alarm in the morning or be too tired to get up, making them late.
  • Avoidance. Children with anxiety commonly avoid the things, situations, or people they are afraid of. They might go to great lengths to avoid these things, but will likely have to face them in the end, which can become a larger issue.
  • Overplanning. Children with anxiety may try to exert their control over feared situations by excessively planning for them, even for things that do not require any. They might tend to focus on worst-case scenarios and feel the need to plan so they can feel in control of the uncertainty.
  • Negativity. Research has shown that individuals with anxiety disorders tend to have more negative thoughts than positive ones. These negative thoughts may come often and are easy to become hyper-focused on. Children may become more prone to these negative thinking patterns, as they may not even realize that they are having those kinds of thoughts or what they can do to change them.
  • Physical Complaints.  anxious children may tend to have a long list of physical complaints, such as headaches, dizziness, stomachaches, muscle aches, racing heartbeat, or shortness of breath. In short, these symptoms can be attributable to excessive anxiety, meaning kids can actually “worry themselves sick.”

Here are some generally lesser-known or misunderstood signs that your child might be experiencing anxiety:

  • Anger/defiance. As discussed above, a child with anxiety may overestimate a perceived threat related to a person or situation and doubt their own ability to cope with it. This can lead them to feel helpless or trapped, which can ultimately turn into anger and defiance. They may become oppositional to take back the control they feel they have lost.
  • Meltdowns/Chandeliering. Anxious children may work hard to keep their worries held inside when they are out in the world (e.g. at school, with friends). But when they get home or to a more comfortable space, they come unglued. They might “chandelier”, or suddenly fly off the handle without warning after appearing calm. This happens when they push their anxious thoughts down for so long that they can no longer hold them in. The meltdown or tantrum may then get triggered by a small or seemingly insignificant event. Bottling up those feelings leads to an eventual explosion.
  • Lack of focus. ADHD and anxiety sometimes go hand-in-hand, and an overlapping symptom between these two conditions is a lack of focus and paying attention. However, the reasons behind are different for each. For children with anxiety, they may get so lost or caught up in their thoughts that they don’t or can’t pay attention to what’s happening around them. This can negatively impact school performance.

What makes children with anxiety act out behaviorally?

No matter what kind or childhood anxiety they may have (separation, social, generalized, phobias, panic disorder, OCD), children with anxiety disorders may have extreme difficulty coping with stressful situations or perceived threats. When they are put into a situation that induces anxiety, they might act out in order to escape or avoid the thing they are worried about. This is not necessarily out of defiance or disrespect, but instead escaping the source of their fear.

Fight/flight/freeze response

A child feeling anxious about taking a test might run out of the classroom to avoid it. Or they may refuse to get out of their chair when asked to present at the front of class. They might throw a temper tantrum at a birthday party if they are nervous about socializing with people. All of these behaviors are examples of the human body’s fight/flight/freeze response. These are the natural ways we react to a perceived threat. Some children with anxiety may tend to freeze up or shut down when presented with stress. Others may try to run away, avoid it, or escape. And some may fight back, get angry, or become disruptive.

Hypervigilance

People with anxiety disorders are often more hypervigilant, or wary of potential threats. They may perceive things to be worrisome or threatening that–in reality– are not. Or, they may see their environment differently than others, and be more on edge. They may focus more on looking out for possible bad things that could happen, instead of what is actually happening. They may also perceive other people as having more hostile or mean intent than they actually do, leading them to respond in out-of-proportion ways to seemingly normal interactions.

Lack of coping skills

Many kids with anxiety struggle to understand and express their feelings with words. Some do not have a supportive outlet to vent their feelings to. In both of these circumstances, the child may be left to express their fears and worries in one of the only ways they know how, with their behavior.

You CAN help your child with their anxiety

The good news is that there are things you can do to help your child if they have anxiety. The following are a few ideas to get you started:

  • Listen to your child’s feelings when they do express them. Don’t deny them or try to downplay them, even if their worries seem small or insignificant. Empathize with and validate them.
  • Praise them when they are doing well. Be sure to express how much you believe in them to boost their self-esteem and sense of capability. Try to praise often, be specific, and consistent.
  • Educate your child on what anxiety is and how our body reacts to stress. You can even explain the fight/flight/freeze response to them, depending on their age. This can help them to get a better sense of what they are experiencing. These can be conversations had over time, rather than all in one go. Talking openly can make it easier for them to discuss and cope with it.
  • Work to figure out your child’s triggers or areas of struggle and try to plan ahead. This might mean waking up earlier in the morning to help with that transition time to school. Or, it could mean blocking out time in the evening to help them study for a test they are worried about.
  • If your child appears overloaded or overwhelmed with things on their schedule, such as sports, activities, or groups, try to give them some more downtime to relax and emotionally reset during their day.
  • Try to maintain a consistent schedule for bedtime, eating, routines, etc. While life isn’t always predictable, this consistency can help children with anxiety feel safe and more relaxed, knowing what is coming ahead.
  • Set limits and help them make better choices. Just because the source of your child’s aggression or tantrums is anxiety, does not mean you should let it slide. You may have to set normal limits and work together with your child to talk about alternate ways to handle their emotions.
  • Work with your child to develop coping skills. Practice deep breathing or grounding exercises together. And practice them throughout the day, not just when they are anxious! It can take a lot of time and practice for skills to set in. You can also help to create a stress-free zone at home with some of their favorite activities (soothing music, coloring books, clay, soft toys, etc.). Communicate with your child’s teacher to allow them to take a soothing item to school to help them cope with anxious feelings during the day.
  • Modify some expectations when appropriate, particularly during moments of heightened stress or worry. For example, you might have a socially anxious child only attend their cousin’s birthday party for the first hour, rather than the whole time.
  • If your child’s anxiety is negatively impacting their daily life, you might consider letting them talk to a therapist. Medication can also be an option to help.

Sometimes anxiety and behavior disorders can overlap. However, behavioral issues tend to stand out and get more attention. This leads adults to focus more on negative behaviors rather than tending to the potential underlying anxiety. It can be hard to focus on the anxiety when behaviors are getting the spotlight, but if you can help your child express the feelings that are trapped or hidden underneath the behavior, you may unlock the key helping them overcome their anxiety AND improve behavior.

Check out our self-guided anxiety course. To view all of our courses, visit selfhelp.strengthenu.com.

Please note, the information in the article above and throughout this website is not a replacement for personal medical advice. If you or a loved one is in need of mental health services, please contact us to request an appointment or reach out to your healthcare provider.

Zara Teichrow, LMSW
Zara Teichrow, LMSW
Zara Teichrow is a licensed social worker.
Zara Teichrow, LMSW
Zara Teichrow, LMSW
Zara Teichrow is a licensed social worker.

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