Anxiety in Children – When Worry Becomes Too Much

Source: Melissa M. Doyle, Ph.D. Department of Pediatrics, Albany Medical College Albany, NY
Pediatrics in Review (Nov 2022, Vol. 43 Issue 11)

Growing Up Can Feel Overwhelming

At Plum Tree, we see it all the time. Bright, caring kids feel stuck in worry. Sometimes it looks like stomachaches before school, tears at bedtime, or the sudden “I can’t do it” moments that leave parents unsure how to help. A little worry is normal, but when anxiety starts getting in the way of everyday life, a child may need more support than reassurance alone can give.

Anxiety Is More Common Than You Think

Dr. Melissa Doyle’s research reminds us that anxiety disorders are among the most common mental-health concerns in children affecting roughly one in ten kids. Yet many go undiagnosed, because their symptoms often don’t look like “anxiety.” They might look like irritability, perfectionism, or physical complaints. In addition, teachers and pediatricians sometimes miss the signs because kids can’t always explain what they’re feeling inside.

Spotting the Signs Early

Dr. Doyle emphasizes one key idea: focus on function, not just feelings.
Ask these questions:

• Is my child’s worry stopping them from doing things they used to enjoy?
• Are school, friendships, or family routines being disrupted?

When anxiety consistently interferes with daily life, it may be time to take a closer look.

What Treatment Looks Like

The most effective treatment for childhood anxiety is Cognitive-Behavioral Therapy (CBT). CBT can help kids gradually face their fears in safe and supported steps. Parents play an important role, too, by resisting the urge to avoid anxiety-triggering situations and instead modeling calm, confident persistence.

In some cases, especially when symptoms are more severe or therapy alone isn’t enough, medications such as SSRIs (fluoxetine, sertraline) can help. These are best managed through collaboration between pediatricians, psychiatrists, and therapists. More on Medication Management Here.

Why Acting Early Matters

Anxiety doesn’t just go away. Left untreated, it can affect learning, relationships, and confidence well into adulthood. But with early intervention, the right tools, steady support, and evidence-based care, most children can experience recovery and learn lifelong coping skills.

How Parents Can Support an Anxious Child

• Validate feelings. “I know that feels scary” can help more than “You’re fine.”

• Encourage small steps. Progress happens one exposure at a time.

• Maintain structure and predictability. Consistent routines calm the nervous system.

• Communicate and collaborate. Keep teachers and providers in the loop so your child gets consistent support.

A Message from Plum Tree

Childhood anxiety is common and we can help. With the right guidance and compassionate care, anxious kids can become resilient, confident, and capable. If you think your child may be struggling with anxiety, our team can help you understand what’s going on and create a clear plan for progress.