Understanding Anxiety in Children and Young People
Understanding Anxiety in Children and Young People
Anxiety in children and young people does not always look like anxiety. It may appear as anger, withdrawal, perfectionism, school avoidance, friendship difficulties, physical complaints or emotional overwhelm. Understanding what a child is experiencing often involves looking beyond behaviour and becoming curious about what that behaviour may be communicating.
Many adults expect young people to tell us when they feel anxious.
Sometimes they do.
More often, anxiety shows up in other ways.
A child may complain of stomach aches before school.
A teenager may become increasingly withdrawn.
A young person may refuse activities they previously enjoyed.
Another may become highly perfectionistic, needing constant reassurance that they are doing things correctly.
When anxiety is viewed only as a behaviour problem, important parts of the story can be missed.
Anxiety Doesn't Always Look Like Worry
Some children openly describe feeling worried.
Others do not.
Anxiety can appear as:
School avoidance
Difficulty separating from parents or carers
Frequent reassurance seeking
Emotional outbursts
Irritability
Withdrawal
Perfectionism
Procrastination
Sleep difficulties
Physical complaints such as headaches or stomach aches
Refusing activities that previously felt manageable
The behaviour we see is often only part of the picture.
Understanding anxiety means becoming curious about what might be happening underneath it.
When School Becomes Difficult
Ethan's Story
Ethan has recently started refusing school.
Each morning becomes a struggle.
His parents are increasingly worried.
Teachers believe he has become disengaged.
Some people see a child who simply does not want to attend.
A closer look reveals a different picture.
Ethan worries constantly about making mistakes.
He finds busy classrooms overwhelming.
Friendships feel increasingly complicated.
He worries about being called upon unexpectedly.
By the time he reaches school, his anxiety is already high.
School refusal is not the beginning of the story.
It is one of the ways the anxiety is being expressed.
The question begins to shift from:
Why won't Ethan go to school?
to:
What makes school feel so difficult right now?
When Anxiety Lives in the Body
Ava's Story
Ava frequently experiences stomach aches.
Medical investigations have found no physical cause.
Yet the pain is very real.
As we explore her experiences, a pattern emerges.
The stomach aches appear most often:
Before school presentations
Before social events
During periods of change
When family stress is high
Young people do not always have the language to explain anxiety.
Sometimes the body communicates it first.
This does not mean symptoms are imagined.
It means that anxiety, emotions and physical wellbeing are closely connected.
When Perfectionism Hides Anxiety
Ben's Story
Ben appears highly successful.
Teachers describe him as conscientious.
He works hard and achieves good results.
Yet behind the scenes, Ben spends hours worrying.
Assignments are repeatedly checked.
Mistakes feel unacceptable.
Praise offers only temporary relief.
The anxiety returns almost immediately.
To others, Ben appears confident and capable.
Internally, he fears getting things wrong.
Sometimes anxiety hides behind achievement.
What looks like confidence from the outside may involve enormous effort on the inside.
When Anxiety Becomes Irritability
Chloe's Story
Chloe has become increasingly argumentative at home.
Small frustrations lead to large reactions.
Family members assume she is being difficult.
Yet Chloe describes feeling overwhelmed most of the time.
Her mind rarely switches off.
She worries about school, friendships and expectations.
The irritability is not separate from the anxiety.
It is one way the anxiety is showing itself.
Children and young people do not always express anxiety through sadness or fear.
Sometimes it emerges through frustration, anger or emotional overwhelm.
Anxiety, Autism and ADHD
This is particularly important when thinking about neurodivergence.
Not everything that appears anxious is necessarily anxiety.
A young person may avoid a noisy classroom because it feels sensory overwhelming.
A child may struggle with change because predictability helps them function effectively.
An ADHD teenager may feel anxious after repeated experiences of forgetting, losing track of tasks or feeling misunderstood.
This is why I take a neurodiversity-affirming approach.
Rather than assuming every difficulty should be challenged, it can be helpful to ask:
What is this young person responding to?
What need is being expressed?
What belongs to anxiety, what belongs to the environment, and where might the two be interacting?
Sometimes anxiety is the primary difficulty.
Sometimes it develops in response to other challenges.
Sometimes both are present.
Understanding the difference matters.
If this resonates, you may also find it helpful to read Anxiety, Autism and ADHD: Understanding the Overlap.
When Anxiety Affects Friendships
Leah's Story
Leah desperately wants friends.
At the same time, friendships make her anxious.
She worries about saying the wrong thing.
She analyses conversations afterwards.
She becomes highly sensitive to changes in messages, tone or social dynamics.
Small uncertainties quickly become significant worries.
Friendship difficulties are common during childhood and adolescence.
When anxiety becomes involved, social situations can begin to feel increasingly risky.
The more threatening they feel, the more likely a young person is to withdraw, avoid or become overwhelmed.
The Role of Reassurance
Many anxious children and young people seek reassurance.
Questions such as:
"Will I be okay?"
"Are you sure?"
"What if something goes wrong?"
"Did I do it right?"
can become frequent.
Reassurance often helps in the moment.
The problem is that the relief usually doesn't last.
The anxiety returns.
More reassurance is needed.
Understanding this cycle helps adults respond with empathy while also helping young people gradually build confidence in their ability to cope.
How Counselling Can Help
Young people do not need to arrive in counselling already knowing what is wrong.
Often they simply know that something feels difficult.
Counselling can provide space to:
Understand anxiety
Explore worries and fears
Recognise patterns
Develop emotional awareness
Build confidence
Explore relationships and friendships
Understand experiences of school, family and social life
Develop healthier ways of responding to stress
Sometimes the most important part of counselling is creating a space where a young person feels heard, understood and accepted.
Not judged.
Not fixed.
Simply understood.
Supporting Parents and Carers
When a child or young person is anxious, parents and carers often feel anxious too.
You may be trying your best to help while feeling unsure what to do.
Understanding anxiety is not about finding somebody to blame.
It is about understanding what may be happening underneath the behaviour.
Once anxiety is recognised, families often find themselves responding differently.
Curiosity begins replacing frustration.
Understanding begins replacing assumptions.
Conversations become easier.
And children often feel less alone in what they are experiencing.
Looking Beyond Behaviour
When anxiety affects a child or young person, behaviour is often the most visible part.
Yet behaviour is rarely the whole story.
Beneath school avoidance, emotional outbursts, reassurance seeking, perfectionism or withdrawal, there may be worries, fears, pressures and experiences that have not yet been fully understood.
Sometimes the most useful question is not:
What is wrong with this child?
but:
What might this behaviour be communicating?
Because when we become curious about what is happening underneath the surface, young people often begin to make much more sense.
A Note About the Examples
The examples in this article are fictionalised and intended for illustration only. They are not based on any individual child, young person or family.
A Note About Support
This article provides general information and is not intended to replace medical, psychological or therapeutic advice.
If you are concerned about a child or young person's mental health or wellbeing, consider speaking with your GP or an appropriately qualified health or mental health professional. If a child or young person is at immediate risk of harm, contact the emergency services.
Anxiety in children and young people does not always look like anxiety. It may appear as anger, withdrawal, perfectionism, school avoidance, friendship difficulties, physical complaints or emotional overwhelm. Understanding what a child is experiencing often involves looking beyond behaviour and becoming curious about what that behaviour may be communicating.
Many adults expect young people to tell us when they feel anxious.
Sometimes they do.
More often, anxiety shows up in other ways.
A child may complain of stomach aches before school.
A teenager may become increasingly withdrawn.
A young person may refuse activities they previously enjoyed.
Another may become highly perfectionistic, needing constant reassurance that they are doing things correctly.
When anxiety is viewed only as a behaviour problem, important parts of the story can be missed.
Anxiety Doesn't Always Look Like Worry
Some children openly describe feeling worried.
Others do not.
Anxiety can appear as:
School avoidance
Difficulty separating from parents or carers
Frequent reassurance seeking
Emotional outbursts
Irritability
Withdrawal
Perfectionism
Procrastination
Sleep difficulties
Physical complaints such as headaches or stomach aches
Refusing activities that previously felt manageable
The behaviour we see is often only part of the picture.
Understanding anxiety means becoming curious about what might be happening underneath it.
When School Becomes Difficult
Ethan's Story
Ethan has recently started refusing school.
Each morning becomes a struggle.
His parents are increasingly worried.
Teachers believe he has become disengaged.
Some people see a child who simply does not want to attend.
A closer look reveals a different picture.
Ethan worries constantly about making mistakes.
He finds busy classrooms overwhelming.
Friendships feel increasingly complicated.
He worries about being called upon unexpectedly.
By the time he reaches school, his anxiety is already high.
School refusal is not the beginning of the story.
It is one of the ways the anxiety is being expressed.
The question begins to shift from:
Why won't Ethan go to school?
to:
What makes school feel so difficult right now?
When Anxiety Lives in the Body
Ava's Story
Ava frequently experiences stomach aches.
Medical investigations have found no physical cause.
Yet the pain is very real.
As we explore her experiences, a pattern emerges.
The stomach aches appear most often:
Before school presentations
Before social events
During periods of change
When family stress is high
Young people do not always have the language to explain anxiety.
Sometimes the body communicates it first.
This does not mean symptoms are imagined.
It means that anxiety, emotions and physical wellbeing are closely connected.
When Perfectionism Hides Anxiety
Ben's Story
Ben appears highly successful.
Teachers describe him as conscientious.
He works hard and achieves good results.
Yet behind the scenes, Ben spends hours worrying.
Assignments are repeatedly checked.
Mistakes feel unacceptable.
Praise offers only temporary relief.
The anxiety returns almost immediately.
To others, Ben appears confident and capable.
Internally, he fears getting things wrong.
Sometimes anxiety hides behind achievement.
What looks like confidence from the outside may involve enormous effort on the inside.
When Anxiety Becomes Irritability
Chloe's Story
Chloe has become increasingly argumentative at home.
Small frustrations lead to large reactions.
Family members assume she is being difficult.
Yet Chloe describes feeling overwhelmed most of the time.
Her mind rarely switches off.
She worries about school, friendships and expectations.
The irritability is not separate from the anxiety.
It is one way the anxiety is showing itself.
Children and young people do not always express anxiety through sadness or fear.
Sometimes it emerges through frustration, anger or emotional overwhelm.
Anxiety, Autism and ADHD
This is particularly important when thinking about neurodivergence.
Not everything that appears anxious is necessarily anxiety.
A young person may avoid a noisy classroom because it feels sensory overwhelming.
A child may struggle with change because predictability helps them function effectively.
An ADHD teenager may feel anxious after repeated experiences of forgetting, losing track of tasks or feeling misunderstood.
This is why I take a neurodiversity-affirming approach.
Rather than assuming every difficulty should be challenged, it can be helpful to ask:
What is this young person responding to?
What need is being expressed?
What belongs to anxiety, what belongs to the environment, and where might the two be interacting?
Sometimes anxiety is the primary difficulty.
Sometimes it develops in response to other challenges.
Sometimes both are present.
Understanding the difference matters.
If this resonates, you may also find it helpful to read Anxiety, Autism and ADHD: Understanding the Overlap.
When Anxiety Affects Friendships
Leah's Story
Leah desperately wants friends.
At the same time, friendships make her anxious.
She worries about saying the wrong thing.
She analyses conversations afterwards.
She becomes highly sensitive to changes in messages, tone or social dynamics.
Small uncertainties quickly become significant worries.
Friendship difficulties are common during childhood and adolescence.
When anxiety becomes involved, social situations can begin to feel increasingly risky.
The more threatening they feel, the more likely a young person is to withdraw, avoid or become overwhelmed.
The Role of Reassurance
Many anxious children and young people seek reassurance.
Questions such as:
"Will I be okay?"
"Are you sure?"
"What if something goes wrong?"
"Did I do it right?"
can become frequent.
Reassurance often helps in the moment.
The problem is that the relief usually doesn't last.
The anxiety returns.
More reassurance is needed.
Understanding this cycle helps adults respond with empathy while also helping young people gradually build confidence in their ability to cope.
How Counselling Can Help
Young people do not need to arrive in counselling already knowing what is wrong.
Often they simply know that something feels difficult.
Counselling can provide space to:
Understand anxiety
Explore worries and fears
Recognise patterns
Develop emotional awareness
Build confidence
Explore relationships and friendships
Understand experiences of school, family and social life
Develop healthier ways of responding to stress
Sometimes the most important part of counselling is creating a space where a young person feels heard, understood and accepted.
Not judged.
Not fixed.
Simply understood.
Supporting Parents and Carers
When a child or young person is anxious, parents and carers often feel anxious too.
You may be trying your best to help while feeling unsure what to do.
Understanding anxiety is not about finding somebody to blame.
It is about understanding what may be happening underneath the behaviour.
Once anxiety is recognised, families often find themselves responding differently.
Curiosity begins replacing frustration.
Understanding begins replacing assumptions.
Conversations become easier.
And children often feel less alone in what they are experiencing.
Looking Beyond Behaviour
When anxiety affects a child or young person, behaviour is often the most visible part.
Yet behaviour is rarely the whole story.
Beneath school avoidance, emotional outbursts, reassurance seeking, perfectionism or withdrawal, there may be worries, fears, pressures and experiences that have not yet been fully understood.
Sometimes the most useful question is not:
What is wrong with this child?
but:
What might this behaviour be communicating?
Because when we become curious about what is happening underneath the surface, young people often begin to make much more sense.
A Note About the Examples
The examples in this article are fictionalised and intended for illustration only. They are not based on any individual child, young person or family.
A Note About Support
This article provides general information and is not intended to replace medical, psychological or therapeutic advice.
If you are concerned about a child or young person's mental health or wellbeing, consider speaking with your GP or an appropriately qualified health or mental health professional. If a child or young person is at immediate risk of harm, contact the emergency services.
Anxiety
Oct 23, 2026