Mental Health Awareness: Spotting Signs of Anxiety in School-Aged Children

May is Mental Health Awareness Month and children’s mental health is a growing concern. Anxiety disorders are among the most common mental health conditions in children, affecting up to 1 in 5 kids and adolescents. They often begin during the elementary school years, and early recognition is the key to getting help.

Feeling worried or nervous sometimes is a normal part of growing up. A child might feel anxious before a big test, on the first day of school, or when meeting new people. But when worry becomes frequent, hard to manage, or starts getting in the way of school, friendships, or family life, it may be more than typical nervousness.

What Does Anxiety Look Like in Children?

Anxiety in children often looks different than it does in adults. Some children may not be able to put their feelings into words. Instead, the anxiety may show up as physical symptoms or changes in behavior.

Physical signs to watch for:

• Frequent stomachaches or headaches, especially on school mornings

• Trouble sleeping or frequent nightmares

• Feeling restless, fidgety, or unable to sit still

• Changes in appetite

• Fatigue or low energy

  
  

Emotional and behavioral signs:

• Excessive worry about everyday things like grades, friendships, or being on time

• Avoiding activities they used to enjoy, such as sports, parties, or sleepovers

• Frequent crying or meltdowns that seem out of proportion

• Asking for reassurance over and over again

• Refusing to go to school or pretending to be sick

• Being more irritable or angry than usual

• Perfectionism or being very hard on themselves

  
  

Common Types of Anxiety in Children

• Generalized Anxiety Disorder: Excessive worry about many things, including school, health, family, and the future. These children may ask many “what if” questions and have trouble feeling reassured.

• Separation Anxiety Disorder: Extreme fear of being away from a parent or caregiver. This can lead to school refusal, crying at drop-off, or difficulty sleeping alone.

• Social Anxiety Disorder: Intense fear of being judged or embarrassed in social situations. Children may avoid speaking in class, eating around others, or attending group activities.

  
  

How Parents and Caregivers Can Help

• Talk openly: Let your child know it is okay to feel worried. Create a safe space for them to share their feelings without judgment.

• Keep routines consistent: A predictable schedule helps children feel safe and secure.

• Encourage healthy habits: Regular sleep, physical activity, and balanced meals can support mental health. School-aged children need 9 to 12 hours of sleep each night.

• Limit screen time: Follow a family media plan and avoid scary or violent content that may increase worry.

• Gently encourage facing fears: Avoiding things that cause anxiety can make it worse over time. Support your child in taking small steps toward facing things that make them nervous.

• Model calm behavior: Children learn by watching adults. Show them healthy ways to handle stress and worry.

  
  

When to Seek Help

If your child’s worry does not improve, lasts for several weeks, or makes it hard for them to go about their day normally, it may be time to talk with a provider.

The good news is that anxiety disorders in children are very treatable, especially when caught early.  At Pediatric Providers, we screen for emotional and behavioral concerns at well-child visits. We can help assess your child and connect your family with the right support, including therapy and prescribing medications if needed.

Maryland Resources for Children’s Mental Health

Maryland has several programs available to help families whose children are struggling with anxiety or other mental health concerns:

• Baltimore County Child, Adolescent and Young Adult (CAYA) Services: The Baltimore County Department of Health Bureau of Behavioral Health offers services for youth with emotional and behavioral concerns. Call 410-887-3828.

• NAMI Metropolitan Baltimore: Provides education, resources, and community support for families affected by mental illness. HelpLine: 410-435-2600.

• Maryland Coalition of Families: Offers free family peer support to help parents navigate behavioral health services. Call 410-730-8267.

• Mental Health Association of Maryland (MHAMD): A statewide education and advocacy agency with resources for children’s mental health. Call 443-901-1550.

• Children’s Mental Health Matters: A statewide initiative providing county-by-county resources for families. Visit childrensmentalhealthmatters.org.

• 988 Suicide & Crisis Lifeline: Call or text 988 for immediate emotional support, available 24/7.

  
  

Local Mental Health Counseling

There are many local options for therapy, both individual and family therapy options. Below is our current referral list. 

A&E Healthcare Services	410-801-9011
Better Help	App
Charlie Health	Online Intensive Therapy
Conduit Behavioral Health	(443) 402-8074
Congruent Counseling (CCS)	(410) 740-8066
First Choice Counseling Center	410-989-9922
Gifts LLC	410-356-2007
Healing Mind Wellness	410-452-4325
Lifestance Health	667-646-5351
Little Otter	Online
Main Street Behavioral Health	410-526-7882
MSA The Child & Adolescent Center	443-259-0400
Playful Therapy Connections	(202) 750-1028
Rose Wellness Counseling	(202) 681-1348
Springboard Community Services	(410) 366-1980
Talkspace	App
Thinking Tree Psychology	Online
Whole Family Healing Group, LLC	(410) 844‑4332

Reliable Sources

• Healthy Children: Help Your Child Manage Anxiety (HealthyChildren.org)

• Healthy Children: Anxiety in Teens is Rising (HealthyChildren.org)

• AAP: Supporting Students with Anxiety in School

• AAP: Anxiety – Pediatric Mental Health Minute Series

• Nemours KidsHealth: Anxiety Disorders in Children

• CHOC: How to Spot Signs of Anxiety in School-Aged Children

• Children’s Mental Health Matters: Maryland Resources by County

• Baltimore County Government: CAYA and Family Services