Understanding and Managing Your Child’s Anticipatory Anxiety

Have you ever found yourself stuck in a cycle of worry about an upcoming event? Maybe it’s a new job, a medical diagnosis, an upcoming vacation—or just the Sunday scaries. Feeling anxious or fearful about a future event or situation that may or may not take place has been termed “anticipatory anxiety,” and it can be debilitating. Children can experience anticipatory anxiety, as well, and, because they have less experience with managing their emotions and are more reliant upon routine, these emotions may be even more stressful for them than an adult. 

What Is Anticipatory Anxiety?

As the name suggests, anticipatory anxiety simply indicates exaggerated worries or fears surrounding an upcoming event or situation. While this condition is usually not considered a specific disorder, as recognized by the Diagnostic and Statistical Manual of Mental Disorders, it can often be a symptom of other anxiety-related disorders, including generalized anxiety,  social phobia, and panic disorder.

For kids, they might worry about everything from huge shakeups in their routine—like back-to-school transitions or changing schools—to smaller events like performing in a school play or a playdate with a new friend.

Yes, everyone worries about the future. Anticipatory anxiety occurs, however, when normal worrying begins to negatively impact functioning. For example: It’s okay if your kid is nervous around an upcoming flight. If they’re so anxious about flying that they can’t eat for days in advance, however, that may be anticipatory anxiety. When the dread is dramatically disproportionate to the situation at hand, stress can have a significant impact on their emotional state.

Some symptoms of anticipatory anxiety are readily apparent. For instance, your child might repeatedly ask about how airplanes work yet seem unsatisfied with your answer. Maybe they display avoidance behaviors like skipping school or asking to quit their basketball team. Other symptoms are subtler: trouble concentrating, irritability, and physical manifestations like nausea or insomnia. 

Dealing with severe anticipatory anxiety in your child may make you scared to try anything new due to their negative reactions. However, understanding the root causes of this anxiety and learning how to support your kid can help the whole family cope with these feelings—and come out more emotionally resilient on the other side.

What Causes Anticipatory Anxiety?

Just like adults, children may experience anticipatory anxiety for a number of reasons. Intense academic pressures mixed with perfectionist tendencies may precipitate anticipatory anxiety for standardized tests, for example. Understanding your child’s emotional landscape better (e.g. do they like to be in control?) can help you prepare for future bouts of anxiety.

Another common trigger for anticipatory anxiety is a change in routine. Studies indicate that routines have psychological benefits, including helping children feel safe and secure. However, even the strictest routines must sometimes be broken—often for great reasons like fun vacations or a chance to challenge your kid academically. Still, just because the routine needs to change doesn’t mean your child implicitly understands why or will easily adapt. 

Change can bring unfamiliarity and unpredictability. Your child may feel a nervousness about the future that manifests via heightened anxiety, as they analyze dozens of possible negative outcomes. What if the kids at their new school don’t like them? What if they can’t hack it academically? 

Anticipatory anxiety is also linked to various anxiety disorders. One study found that children with these disorders saw increased amygdala activation during surprising or uncertain events. This might indicate their brains work harder to process uncertainty. 

By paying attention to your child’s patterns and worries, parents can play a crucial role in navigating transitions and coping with anticipatory anxiety in a healthy way.

How to Identify Anticipatory Anxiety

Being able to recognize the symptoms of your child’s anticipatory anxiety is the first step to getting them help. While visible fretting isn’t the only symptom, if your child is chronically anxious about upcoming events they may be experiencing anticipatory anxiety. 

Here are several other signs to look out for: 

• Fear or dread of the future
• Restlessness or irritability
• Physical symptoms like headaches, stomach aches, or insomnia, especially when they happen before a big event
• Avoidance behavior, like refusing to participate in new activities—even ones they may have been excited about before

Pay attention to these symptoms as they occur. The sooner you recognize anticipatory anxiety, the sooner you can mitigate its effect on your child’s life. Left unaddressed, this anxiety could impact their performance in school, their relationships with their friends, and their overall well-being. Prompt intervention reduces the likelihood that the anxiety escalates. Just as with most medical treatment, early mental health interventions are most effective. 

If you think your child is experiencing anticipatory anxiety, it may be time to consult a licensed mental health professional. 

How to Deal With Anticipatory Anxiety

Understanding your child’s feelings will help you navigate the murky waters of anticipatory anxiety. Prioritize open, sympathetic communication, allowing them to express their fears—even if, or especially if, they’re scared of your reaction. For example, your child might be worried you’ll be angry because they feel unprepared for a test. It’s important to validate those feelings, but reassure them it’s okay to feel anxious.

Transitions and other major changes in routine, like big vacations or the end of summer and the prospect of returning to school, can be huge triggers for anticipatory anxiety and so it’s important to start preparing your children for changes early. Begin talking about the transition in advance: “In two weeks, we’re going to be getting on a plane to visit Disney World.” When the event draws closer, prepare them more explicitly by adjusting sleep schedules, if necessary, and talking about their fear of the unknown.

Still, even the best preparation can’t necessarily head off all of your child’s anticipatory anxiety. Remind your child that anxiety is normal, and everyone experiences it sometimes. Teach self-care, including mindfulness and relaxation techniques. Help your child meditate or walk them through progressive muscle relaxations. Creative activities, like drawing or music, can help relieve anxiety, too. And don’t forget the body! Regular exercise can be a natural stress reliever. 

Integrating these practices into a daily routine will help your child develop healthy coping mechanisms. 

How to Stop Anticipatory Anxiety After It Starts

If your child is already deep in the anticipatory headspace, it can be difficult to jolt them out, but there are some strategies that can improve things. First: Help your child recognize and challenge their anxious thoughts. Why are they so scared of their final exam, for example? Perhaps they’re worried that if they fail, they’ll be kicked out of school, never get into college, and so on and so forth. Worse case scenarios, exaggeration, and misinterpretation often fuel anxiety. Framing situations in a more positive light can help defuse the worry.

Those grounding techniques mentioned above, like meditation or progressive muscle relaxation, can also be lifesavers in the moment. Ask your child to focus on their breathing, name objects in the room, or feel something textured, like a soft blanket. These techniques divert attention from anxious thoughts, bringing the child back to the present.

How to Treat Anticipatory Anxiety

If anticipatory anxiety becomes too severe to manage with support and coping skills, consider bringing in a mental health professional. A licensed therapist can dig into the reasons behind the anxiety and develop personalized coping strategies for your child.

Cognitive behavioral therapy, or CBT, is a common treatment modality that works well for anticipation anxiety. CBT helps children understand their thoughts and feelings and to identify the connection between those events and their own behaviors. With the help of their therapist, your child can learn how to challenge their anxious beliefs in the moment. 

If your child continues to struggle with anticipatory anxiety after therapy, medication may be necessary. Many doctors consider selective serotonin reuptake inhibitors—or SSRIs—the best antidepressant for anxiety, including anticipatory anxiety. There are a number of medications that might be suitable, and even SSRIs aren’t a one-size-fits-all solution. Your child’s pediatrician or a child psychiatrist can determine the best medication for their needs. 

Anticipatory anxiety can be disruptive, diminishing your child’s enthusiasm for new activities or adventures, but learning if a child’s symptoms are due to anxiety can also help you recognize when it’s time to seek help. Remind your child that it’s normal to be anxious about the future, and reassure them you’re available to talk through their worries. Teaching your child to practice mindfulness and other self-care techniques—and calling in the professionals if needed—can help you to manage your child’s anticipatory anxiety and fortunately there are proven treatments available to manage the condition. 

For help with a child’s anticipatory anxiety, start with a free consultation from a licensed Handspring Health therapist today.