Anxiety in children: body signs

Childhood anxiety often arrives through the body before it arrives through words. A child who cannot name what they are feeling will still feel it — in their stomach, their head, their sleep. If the doctor cannot find anything, this page is for you.

The body signals worth knowing

• Recurrent tummy aches, often around the navel, usually worse in the morning before school and settling on weekends.
• Headaches that come and go, unrelated to hydration or eyesight.
• Nausea or loss of appetite in specific situations (before school, before sleep, before a specific event).
• Difficulty falling asleep — lying awake with racing thoughts; 'I can't sleep' without a named reason.
• Frequent waking or early-morning rising.
• Needing to pass urine frequently without a urinary tract infection.
• Chest tightness or shortness of breath with no respiratory illness.
• A marked change in energy — either withdrawal or agitation.

Why the body shows anxiety first

The autonomic nervous system and the gut-brain axis are tightly linked. When a child's threat system activates, their gut is one of the first places the shift shows up. The child feels a real, physical pain — it is not made up, it is not attention-seeking, it is the physical expression of a brain state they do not yet have the vocabulary to name.

How to tell whether it is anxiety — and not something medical

The first step is always a medical review. Recurrent tummy aches, headaches, or other symptoms always warrant a GP visit to rule out physical causes.

Once a medical cause has been reasonably ruled out, the pattern to look for is situational. A tummy ache that appears on Sunday evening and Monday morning but is absent on Saturday is telling you something about Mondays. A headache that appears before a test and settles after is telling you something about tests.

Listen for what comes up around the body-state. Not 'what's wrong with your tummy' — you already know. 'What's on your mind today?' 'Anything you're not looking forward to?'

What helps

1. 1Validate the physical feeling. 'Your tummy really hurts. That's hard.' Do not argue with the sensation.
2. 2Name the possibility. 'Sometimes our tummy aches when we have big feelings. Is there anything your tummy might be worried about today?' Gentle, not forced.
3. 3Hold the line on the thing being avoided — usually school. Staying home creates a short-term relief that strengthens the avoidance pattern.
4. 4Build a small predictable morning routine. Anxiety hates novelty; structure is calming.
5. 5Teach the body a regulating skill — three long exhales, a hand on the belly, a minute of cold water on the wrists. These are evidence-based, not wellness trinkets.

When to seek a psychologist

• Symptoms are recurrent over more than a month.
• School attendance is being affected.
• The child cannot name what they are worried about, but the body is clearly activated.
• You have tried the steady steady steady approach and the pattern is not easing.
• Your instinct is that something specific is going on and the child cannot say what.

In Australia, a GP Mental Health Care Plan unlocks up to ten subsidised psychology sessions a year. CBT — cognitive behavioural therapy — is the evidence-based first-line treatment for childhood anxiety. It works. Do not wait six months to access it because it sounds clinical.