How to Manage Childhood Fears and Worries as a Parent

As kids grow, they have a lot of fears and worries that they’re learning to deal with. From monsters under the bed to peer pressure, these feelings can be a normal part of childhood. But sometimes fears and worries can cross over into a place where they negatively affect a child. You can help your child by giving them a safe space to express their feelings openly. 

In addition to exploring how you can help your child with anxiety, we’ll cover how to recognize signs of anxiety, how to respond, and where to go when you need help.

Is it fear and worry, or is it anxiety?

Fear and worry are very common in children. Different worries pop up at different phases of physical and emotional growth (developmental stages). These worries are considered “developmentally appropriate.” This means that they’re a normal part of human emotional and social development. Childhood fears and worries also change over time. For example, a baby or toddler can be afraid to separate from their parents; young children are often afraid of the dark; and teens may worry about a big presentation at school. These worries are there as a warning system about something that’s either unknown or doesn’t feel right. They’re our natural protectors to keep us safe.

Anxiety in children is fear and worry that they don’t outgrow or that can interfere with school, home, or play. Anywhere between 7% and 20% of children and adolescents are diagnosed with anxiety. COVID-19 has led to an increase in anxiety in kids. And recent estimates report a doubling in the levels of anxiety and depression in kids and adolescents since the pandemic began.

The major categories of anxiety in kids include:

• Separation anxiety

• Phobias (fear of an object or situation)

• Social anxiety

• Generalized anxiety

How do children and adults show anxiety differently?

Kids aren’t just little adults. Adults can often verbalize their experiences of fear, stress, and worry that bring about anxiety — but most kids cannot. As a result, anxiety in kids can show up both physically and emotionally. And in terms of development, kids across different ages can have different outward signs of anxiety. 

Some of the more commons signs and symptoms of anxiety in children are:

• Physical complaints like stomach aches or headaches

• Avoidance of people, places, or things

• Sleep disturbance

• Repetitive thoughts or actions (obsessive compulsive behaviors)

• “Bad” or scary thoughts

• Fear of embarrassment or mistakes

• Eating problems or refusal to eat

• Selective mutism (not talking)

• Behavior regression (like bed-wetting)

• Self-soothing behaviors like nail-biting

• Low self-esteem or confidence

• Acting out

• Change in social interactions or withdrawal from social groups

How will my child tell me that they have anxiety?

Most children won’t be able to tell an adult they have anxiety. A lot of times, parents have to be really good detectives to figure it out. Some ways that can help to encourage kids to open up about their feelings include the following:

• Build trust and connection. Just telling a child that they can trust you usually isn’t enough. Kids will only open up to an adult with whom they feel safe and protected. Establish and reinforce trust early and often with your child so they know they can come to you with these confusing and difficult topics.

• Encourage open communication and nonjudgement. Some of the biggest worries of childhood are that they will get in trouble, that their parents will be upset with them, or that their worries and fears will not be kept private. Kids need to feel that they can talk openly and honestly, and that there’s no worry that is so big that their parents can’t handle it. 

Foster a relationship of open communication and nonjudgement with your child so that they don’t close off their feelings. Have an open-door policy that they can come to you whenever they need to. Some children even benefit from having a signal with their trusted adult that means they need to talk.

• Talk their talk. Every child has their own way of connecting and communicating. For example, some kids like to think and talk at night after the day’s activity is over. Some kids express their worries and fears in pictures or imaginative play. Being in tune with your child and their language of communication will help your child feel safe and trusting. This allows them to share what’s on their mind.

• Schedule time. Purposefully creating opportunities for one-on-one time with your child takes the pressure off of the child to create it themselves. Most children will not open up about these types of feelings in a group setting. Scheduling individual time allows them to know that there’s an opportunity to talk privately.

How should I react if my child says they’re worried, stressed, or scared?

• Listen: Instead of rushing to offer your opinion or a solution, just listen. There are lots of active listening tools that parents can use to make children feel that you’re fully engaged in what they’re telling you. Sometimes kids aren’t even looking for a solution, they just want to be heard. With older children, it’s even OK to ask them if they want you to just listen or to offer help to fix the problem.

• Validate: How your child feels about their worry is equally as important as what that worry is. For a child who hasn’t learned how to weigh what is a big deal and what is not, even a small worry can lead to distress. 

Telling a child that they shouldn’t worry about something usually doesn’t work. It’s much more helpful to tell a child that you understand how scary their thoughts must be to them. For example, you don’t need to agree that there’s a scary monster hiding in the closet. You just need to tell the child that you understand how scary that is to them. You don’t have to agree to provide validation.

• Control your own reaction: Kids look toward their parents’ reactions for their own measurements of fear, shame, and value. Sometimes what your kids tell you can trigger big reactions in you — but your kids reactions may not be the same as yours. Try to control your own reactions, even if what you hear is alarming. This often requires parents to listen first and wait to react. This isn’t not an easy task, to be sure. Instead, explore how they feel before passing judgment on a situation or naming the emotions for them.

• Triage: Just like in a hospital where a quick assessment of severity is the first step, parents should try to determine how serious things are. Is the child safe or at risk of harming themselves or others? Is there a physical component to the anxiety that can be harmful, such as not eating? These are only some of the reasons to seek outside help.

When should I get help for my child’s anxiety?

If there’s any question at all in your mind, always talk to your child’s healthcare provider. Oftentimes, we don’t think to turn to them when it comes to worry and anxiety. But pediatricians and family doctors are just as knowledgeable in these needs as they’re in the physical wellness of a child.

Here are some signs that your child's feelings are bigger than what you can deal with at home:

• Your child is a threat to themselves.

• Your child is a threat to others.

• Your child is experiencing harmful physical changes (e.g., not eating, not sleeping, or cutting themselves).

• Your child’s behaviors are getting more frequent or more intense.

• Your child’s behaviors are causing increasing amounts of disruption in the day-to-day life of your child or your family.

How do I know if my child is in crisis?

According to the Association for Children's Mental Health, “a crisis situation exists any time that your child is no longer safe to himself or others or when there is a need for immediate action or intervention.” 

If your child is in crisis you can:

• Call your local community mental health emergency services.

• Call your local police.

• Go to your nearest emergency room.

The National Suicide Prevention Hotline is available 24 hours a day: 1-800-273-8255.

What kind of help exists for children with anxiety?

There are different types of help and treatment available to children with anxiety. Most treatments for kids start with some form of therapy. Examples include play therapy, talk therapy, and cognitive behavioral therapy. Medications for anxiety are less commonly used in children than in adults. There are also some newer treatments that focus on helping parents gain skills to manage the child’s anxiety instead of focusing on the child. Treatments can be one at a time or layered on top of each other for the most benefit and integrated care. 

Speak with your healthcare providers to determine the best kind of help for you and your child.

What are things I can do at home to help my child?

If you have determined that your child isn’t in crisis, there are some things that you can do at home to help with anxiety:

• Create a place of comfort. Sometimes kids just need a place to calm down. Creating a place in your home that functions as a safe and comforting place can help. If they like to read, place a book in that space. If they like art, add a few supplies like paper and pencils. Make it cozy and comfy, and don’t make it a place for negative consequences or punishment. Instead, it should be for time to settle and refill.

• Externalize emotions. A lot of kids don’t know how to safely express their feelings or how to feel more than one emotion at a time. For example, being upset with someone they love can be very confusing to a child. 

Parents can lead by example and model how to talk about feelings as a normal part of their day. For example, how does your body feel when you have big or small feelings? Describe different points in your own days when you were happy, and another when you had a different emotion such as frustration or anger. There are several other ways to encourage kids to get their feelings out, including drawing and journaling. Find out what works for your child — it may take trying different things to see what feels the most comfortable.

• Don’t make emotions negative. Anxiety and depression carry a lot of misconception and shame. But humans have a full range of emotions, both good and bad. It’s important to let kids know that emotions like sadness, frustration, and anger are normal and OK to express. 

As an adult, try to be careful about the words you choose when kids feel upset. This way you won’t associate fear and worry with something negative. Emotions are simply important information — there is no “good” or “bad.”

• Don’t avoid it. Try not to let the child avoid what is making them anxious. Avoiding it makes the fear bigger over time and reinforces the worry.

Where can I find more information and resources?

If you’re looking for more information, some useful places to look include:

• The American Academy of Child and Adolescent Psychiatry promotes mental health in children of all ages and in families through education, advocacy, and research.

• The American Psychological Association is the leading organization representing the field of psychology in the U.S.

• The Center for Effective Parenting aims to help children by helping parents and anyone who works with parents to learn skills, attitudes, and information about parenting.

• The Child Mind Institute aims to fill the gap for nearly three-quarters of U.S. counties that don’t have child mental health services. They provide educational resources to families and professionals to help children with both mental health and learning challenges.

• Positive Parenting Solutions aims to help parents approach their own children — from toddlers to teens — without yelling, nagging, or losing control.

Why trust our experts?

Written by:

Rebecca Horn, MD, MPH

Dr. Horn is a physician and public health specialist, with experience on four continents. She specializes in anesthesia and critical care and has a particular interest in perioperative care, as well as obstetric anesthesia.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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