Anxiety in Children

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Everyone experiences anxiety, including children. Most times it's temporary, and children can cope or be comforted and experience relief. In some cases, anxiety may be characterized by excessive fear, nervousness, or shyness that impairs functioning to the point that your child avoids certain places and activities. Some children may also have persistent physical symptoms such as headaches or stomach pains. If your child is showing extreme worry that is interfering with their normal life and functioning, Duke's behavioral health team can help them learn to cope effectively with anxiety.

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Common Signs of Childhood Anxiety

If you're concerned about your child’s behavior, don’t hesitate to contact us for help. Children often outgrow these thoughts, feelings, and behaviors on their own, but if they persist or create disruption in your family life, we can help find solutions.

Signs of anxiety can appear at any age, and may include:

  • Extreme discomfort or fear of sleeping alone, going to school, having a new babysitter, going to birthday parties or on play dates, or participating in after-school programs. We can evaluate whether treatment might help your child manage these fears.
  • Painful shyness with peers (although not with parents or siblings), fear of giving oral reports, lacking friends of the same age, or refusal to play sports for fear of someone laughing at their performance. This type of anxiety -- called social anxiety -- most often appears around school age, and teachers are often a good resource for recognizing when this may be present. Our team can work with your child to identify strategies to help them increase their confidence and comfort in interacting with peers.
  • Intense worry on a range of issues, from a parent’s health or financial situation to severe weather, to getting admitted to college. We can help manage the constant worry associated with generalized anxiety that can lead to poor sleep, irritability, and problems with concentration.
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Duke Health offers locations throughout the Triangle. Find one near you.


Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is an evidence-based treatment for anxiety disorders. It is designed to help a child develop coping strategies to more effectively manage the thoughts, situations, or objects they fear. CBT can be delivered in individual therapy sessions or in group therapy. Therapy generally requires a series of weekly sessions with a Duke behavioral health provider who specializes in anxiety. Parents and caregivers are involved in their child’s treatment and may be asked to participate in family sessions to support their child’s progress.  


Medications can help reduce anxiety and are sometimes used in conjunction with cognitive behavioral therapy. Our psychiatrists are skilled at managing and adjusting dosages that will be most effective for your child.

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Why Choose Duke

Evidence-Based Treatment
There are many effective treatments for anxiety and anxiety-related disorders. Our team of psychiatrists, psychologists, social workers, and nurses provides compassionate, evidence-based treatment in an environment designed to help your child feel safe and comfortable. We conduct all evaluations and treatment with great sensitivity and respect for the unique needs of your child and your family.

Active Research
Our anxiety experts have been involved in the study of childhood anxiety for many years. We keep pace with -- and often lead -- new studies and developments in the treatment of anxiety.

A Team of Specialists
For children who have serious or chronic physical illnesses, we have teams of specialists both in the hospital and in our outpatient clinics who are sensitive to the strain these illnesses can cause. They can help your child overcome anxiety related to their illness or medical treatment.

Best Children's Hospital in NC

Duke Children's Hospital & Health Center is proud to be nationally ranked in 10 pediatric specialties.

This page was medically reviewed on 08/09/2022 by