What Child Anxiety Actually Looks Like (Not Just Tantrums)
When people think of child anxiety, they often imagine a nervous child wringing their hands, or maybe a toddler clinging to their parent’s leg and crying at drop-off. But in reality, anxiety in kids can look very different—and much harder to spot.
As a child anxiety therapist, I’ve seen anxious kids present in ways that most people would never label as anxiety. Often, their behavior is misunderstood as defiance, manipulation, or attention-seeking. But underneath the surface? There's fear, uncertainty, and a brain trying to stay safe.
Let’s look at some of the less obvious ways anxiety can show up in kids.
1. Perfectionism
Anxious children may place immense pressure on themselves to do things “just right.” They might rip up homework repeatedly, obsess over tiny details, or avoid starting projects altogether out of fear they won’t do them perfectly. These kids may seem like high achievers—but their drive is rooted in fear, not confidence.
2. Frequent Physical Complaints
Stomachaches. Headaches. Nausea. Fatigue.
These aren’t “faking it” or attempts to get out of school—they’re very real physical symptoms of anxiety. A child who constantly visits the school nurse or avoids certain situations because they “don’t feel good” might be dealing with anxiety in disguise.
3. Avoidance of People, Places, or Activities
An anxious child might refuse to go to school, avoid birthday parties, or get overwhelmed when asked to try new things. They may say “I don’t want to,” but the truth is often: I’m afraid and I don’t know how to handle it.
4. Reassurance-Seeking and Overthinking
“What if I get sick?”
“What if you die?”
“What if I forget something?”
Anxious kids often get stuck in loops of “what if” thinking. They ask the same questions again and again—not because they didn’t hear you, but because anxiety never feels fully satisfied with the answer. Reassurance may calm them briefly, but the fear tends to creep right back.
5. Sleep Struggles
Many anxious children have trouble falling asleep, staying asleep, or sleeping alone. Their minds race with worry at night, and the quiet darkness can feel overwhelming. You might notice them stalling at bedtime, getting out of bed repeatedly, or waking up with nightmares.
6. Sensitivity to Criticism and People-Pleasing
Some anxious kids are model children—well-behaved, kind, and eager to please. But underneath their compliance may be a deep fear of disappointing others or being seen as “bad.” Even small corrections can feel devastating to a child whose inner world is already full of self-doubt.
7. Big Reactions and Explosive Behavior
Yes, anxiety can look like tantrums. When a child’s fear system is overloaded, they may lash out—yelling, crying, or even becoming aggressive. These outbursts often happen in moments of overwhelm when they don’t have the words or tools to express what’s going on inside.
The Bottom Line
Anxiety isn’t always loud. It’s not always obvious. And it doesn’t always show up as fear.
In fact, many anxious children fly under the radar for years—seen as sensitive, dramatic, rigid, or even lazy—when really, they’re doing their best to navigate a world that feels unpredictable and scary.
If this sounds like your child, know that you’re not alone—and that with the right support, kids can learn to understand their anxiety, face their fears, and grow their confidence.
Want more support understanding and helping your anxious child?
Follow along @therapy_hannah_ for more tips, resources, and encouragement.
