When to seek help for childhood anxiety: the red flags

By Tim Khuja · 8 min read

Last reviewed June 9, 2026

Every child worries. Worry is part of a developing brain learning to predict the world. Most of the time, anxiety comes in waves — a hard week, a tricky transition, a phase — and gradually settles with co-regulation, predictability, and time.

But sometimes it doesn't settle. Sometimes it grows, narrows a child's life, and starts to cost more than it's costing them to feel.

Here's how to tell the difference.

The 4-question filter

When anxiety is making you wonder, ask:

1. How long? Has the anxiety been present most days for more than four weeks?
2. How much? Is it interfering with sleep, eating, school, friendships, or play?
3. How wide? Is it spreading — affecting more situations, more days, more parts of life?
4. How costly? Is your child losing things they love because the anxiety is in the way?

If the answer to two or more of these is yes, it's worth a conversation with a professional.

Specific red flags

Physical signs

• Frequent stomach aches or headaches with no medical cause
• Sleep disruption that lasts beyond a couple of weeks
• Changes in appetite (eating much less or much more)
• Bedwetting in a previously dry child
• Hair pulling, skin picking, nail biting that breaks skin

Behavioural signs

• School refusal lasting more than a few days
• Avoiding things they previously enjoyed
• Asking the same reassurance questions repeatedly
• Rigid routines that, if broken, cause significant distress
• New rituals (handwashing, checking, counting) that take time and cause distress if interrupted

Emotional signs

• Frequent panic-like episodes (racing heart, trouble breathing, "I'm going to die")
• Selective mutism (cannot speak in certain settings)
• Persistent low mood, hopelessness, or "I wish I wasn't here" statements — seek help immediately
• Significant regression in skills (toileting, sleeping alone, speech)
• Disconnection: a child who seems flat, far away, or no longer themselves

Family signs

• Anxiety is dominating family life
• You feel like you're walking on eggshells
• Siblings' lives are being shaped by it
• You as the parent are exhausted, scared, or out of strategies

What "getting help" can look like

It doesn't have to mean weekly therapy forever. Often a few sessions with the right professional can shift things significantly.

• GP / paediatrician: good first stop, especially for physical symptoms.
• School counsellor or psychologist: often free and already knows the school context.
• Child psychologist or clinical psychologist: trained in CBT, play therapy, and family approaches.
• Child psychiatrist: if medication might be part of the conversation, or for complex presentations.
• Occupational therapist: if sensory processing seems to be in the mix.

What to say to your child

Keep it light, normalising, and matter-of-fact: "We're going to talk to someone whose job is helping kids with big worries. Lots of kids see them. They have really good ideas."

Don't frame it as something being wrong with them. Frame it as a tool — the way you'd see a coach for a sport you wanted to get better at.

A gentle reminder

Seeking help isn't a failure. It's parenting. The earlier anxiety gets support, the easier it is to shift — and the more your child gets to learn that hard things are workable, and that asking for help is a strength.

If you're reading this and wondering, that wondering is data. Trust it.