Anxiety is one of the most common mental health challenges facing children and teenagers today, and yet one of the most frequently overlooked. Parents often mistake anxiety for shyness, stubbornness, or simply "a phase," while the child quietly struggles beneath the surface. As a licensed child psychologist serving families in Encino and the San Fernando Valley, I see this pattern regularly — and the good news is that effective treatment exists.
Anxiety in young people can take many forms. Some children worry excessively about school performance, friendships, or family matters. Others experience physical symptoms like stomachaches, headaches, or difficulty sleeping with no apparent medical cause. Still others avoid situations that trigger fear — refusing to go to school, declining social invitations, or becoming distressed when separated from a parent.
"The child who seems stubborn or difficult may actually be struggling with anxiety they don't yet have the words to describe."
Common Signs of Anxiety in Children
While every child is different, some of the most common signs of anxiety in school-age children and adolescents include:
- Persistent, difficult-to-control worry about everyday matters
- Irritability, emotional outbursts, or sudden mood shifts
- Difficulty concentrating or staying on task at school
- Avoidance of feared situations (school refusal, social withdrawal)
- Physical complaints — stomachaches, headaches, fatigue — without a medical cause
- Constant reassurance-seeking from parents or teachers
- Sleep difficulties: trouble falling asleep, nightmares, or reluctance to sleep alone
In adolescents, anxiety may also appear as withdrawal from friends and activities that were once enjoyable, declining academic performance, increased reliance on screens as avoidance, or in some cases, risk-taking behavior as a way of managing internal distress. It is also worth noting that anxiety and depression frequently co-occur in teenagers — a teenager presenting with one condition should be carefully evaluated for the other.
Why Anxiety Goes Unrecognized
Several factors contribute to anxiety being missed or misidentified in young people. First, anxious children often appear well-behaved on the surface. They may comply, over-prepare, and avoid situations quietly rather than acting out — drawing less attention than children whose distress looks more disruptive.
Second, the physical symptoms of anxiety (stomachaches, headaches, nausea before school) frequently lead families down a medical route first, with pediatric workups coming back normal before the psychological component is recognized. Third, many children lack the vocabulary to describe internal states — they may not say "I'm anxious" but instead say "I don't feel well," "I don't want to go," or simply shut down.
What Parents Can Do
The most important thing a parent can do is listen without minimizing. Statements like "there's nothing to worry about" — though well-intentioned — can inadvertently communicate that the child's feelings are wrong or invalid. Instead, try acknowledging the feeling directly: "I can see you're really worried about this. Let's talk about it."
It is also important to resist the urge to remove every anxiety-provoking situation from your child's life. While this provides short-term relief, it reinforces avoidance and makes anxiety stronger over time. Children learn that feared situations are genuinely dangerous precisely because we help them escape. A skilled therapist can help children and families develop strategies for gradually facing fears in a supported, manageable way — a process known as graduated exposure.
Other steps parents can take at home include maintaining predictable daily routines, validating feelings without reinforcing avoidance, and modeling calm, regulated responses to stress. Even small shifts in how a parent responds to a child's anxious behavior can make a meaningful difference over time.
When to Seek Professional Help
If anxiety is interfering with your child's daily functioning — school attendance, friendships, sleep, family life, or participation in activities they once enjoyed — it is time to consult a mental health professional. Anxiety that goes untreated tends to persist and, in many cases, worsen over time.
Evidence-based treatments such as Cognitive Behavioral Therapy (CBT) have robust research support for childhood and adolescent anxiety. CBT helps children identify the thoughts and patterns driving their anxiety, challenge unhelpful thinking, and gradually engage with feared situations in a structured, supportive way. For younger children, Parent-Child Interaction Therapy (PCIT) and parent-focused interventions are often incorporated as well, recognizing that children's anxiety is best treated within the context of the family system.
With appropriate treatment, meaningful improvement is not only possible — it is the norm. Many children and adolescents show significant gains within a few months of consistent, evidence-based care.
