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Anxiety in Kids

My child is always worried. Is that normal?

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Dear Doctor,

My son seems to spend a lot of time worrying. Is this anything I need to be concerned about? Or will his anxiety go away on its own as he gets older?

Sincerely,

"Worried about the Worrying"

Dear Worried:

Anxiety in moderation is a normal, healthy reaction that we need to keep us safe. In fact, I worry about the kid who isn’t anxious. He’s not going to look both ways before he crosses the street, or hesitate when a friend asks if he wants to try vaping. If kids are too anxious, however, that’s a problem. But it’s one that can be treated.

Kids have fears that come and go as they age. Toddlers, for instance, often cry when they’re separated from their parents. A 6-year-old may be afraid of going to the doctor, and a teenager may be nervous that nobody will sit with him at lunch on the first day of high school. These are all normal, age-appropriate fears. Once the child navigates the situation, the fears will likely go away on their own. The toddler who was afraid of walking into her preschool class in September will be running in as she waves goodbye without a tear by January.

But some kids are unable to navigate the situations on their own; they feel anxiety above and beyond the typical level. To help work out what’s normal and what’s not, the overarching, most important question you need to ask yourself is: Does your child’s anxiety interfere with his daily life? If your child is skipping school, staying home from parties, or losing sleep and becoming irritable, it’s possible that they might have an anxiety disorder, which is characterized by persistent, irrational, and overwhelming worry, fear, and anxiety that interfere with daily activities. If you suspect that is what’s going on, it’s important to discuss it with your pediatrician. And ask for a referral to a psychologist or social worker for a more formal evaluation.

There’s a lot of research to suggest if you don’t treat anxiety disorders in kids, it will interfere with the child’s social, academic, and emotional development. Cognitive behavioral therapy (CBT) is the most effective, evidence-based treatment for childhood anxiety. This talk therapy helps your child recognize and replace negative thinking and behaviors with positive ones. It also helps him learn to see the situation in front of him more realistically, instead of seeing a catastrophe around every corner.

If the anxiety is severe, a child may also need medication, at least for a while, to help them get the benefits of therapy. One large study found that after 12 weeks of treatment, 60 percent of children were significantly better with CBT alone compared to a placebo, and 81 percent of kids were significantly better with a combination of CBT and medication.

When kids with excessive anxiety get the help they need, they’re better able to flourish.

“The overarching, most important question you need to ask yourself is: Does your child’s anxiety interfere with his daily life?”
Dr. Victor M. Fornari, child psychiatrist
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Dr. Victor M. Fornari, child psychiatrist | Photo credit: The Well

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Published February 26th, 2019
A young woman with dark curly hair is using mobile phone. Female is smiling while holding smart phone. She is lying on sofa at home.

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