When a Stomachache Is More Than a Stomachache: How Anxiety Shows Up in Kids
“My son has always had some anxiety since he was a toddler,” one parent recently wrote in an online chat. When school became more stressful, she says things changed. Her 7-year-old began complaining of a “nervous stomach,” crying at the school gate, and sometimes ending up in the nurse’s office.
It turns out that her child’s stomachache was more than a stomachache. It was anxiety.
For parents, recognizing childhood anxiety may be a challenge. A child may never say, “I’m anxious.” Instead, the clues may appear at bedtime, before school, or in seemingly unexplained changes in behavior. In this case, it appeared as stomachaches.
“What appears to be defiance, irritability, or withdrawal may actually be a child struggling to manage overwhelming emotions,” says Dr. David Timpanaro, CEO of Step Up Family Services. “Anxiety in children doesn’t always look like what adults expect anxiety to look like. Sometimes a stomachache really is the first clue that a child is struggling emotionally.”
When Anxiety Shows Up in the Body
Headaches, stomachaches, trouble sleeping and changes in appetite can accompany anxiety in children. Other signs may include irritability, difficulty concentrating, becoming unusually clingy or avoiding school and activities they once enjoyed.
The American Academy of Pediatrics notes that physical complaints can be among the first signs of an anxiety disorder in children.
“That’s why changes in behavior matter,” Timpanaro says. “Parents know their children. If your child suddenly doesn’t want to go to school, stops doing something they normally love or constantly complains that they don’t feel well, it’s worth asking what else may be going on.”
Not every worried child has an anxiety disorder, however. Feeling nervous before a test, starting a new school or facing an unfamiliar situation can be a normal part of childhood. The bigger concern is when anxiety becomes persistent or begins interfering with everyday life.
What Parents Can Do
The first step may be surprisingly simple: listen.
“You don’t have to immediately solve the problem,” Timpanaro says. “Give your child a chance to tell you what they’re feeling. Let them know you believe them and that you’re going to work through it together.”
Parents can also look for patterns. Does the stomachache happen mostly on school mornings? Does bedtime become harder before certain activities? Has something recently changed at school, at home or with friends?
Maintaining predictable routines can help, too. And rather than simply removing everything that makes a child anxious, parents can help children gradually learn how to cope with difficult situations.
If anxiety is persistent, getting worse or interfering with school, sleep, friendships or everyday activities, Timpanaro recommends talking with a pediatrician or mental health professional.
“Children don’t have to figure out anxiety on their own,” he says. “Sometimes the most important thing a parent can do is notice that something has changed and take it seriously.”
