WHEN ANXIETY SHOWS UP AS A STOMACHACHE: IDENTIFYING ANXIETY IN KIDS

I once saw a meme that said:

“Were you a pleasure to have in class, or were you an eldest daughter with an undiagnosed anxiety disorder?”

And I remember thinking: Who says I wasn’t both?

I am the daughter of a school social worker and was raised in a home where mental health was normalized and openly discussed. And yet, throughout my childhood, I experienced frequent headaches that were viewed exclusively as a medical issue. I have vague memories of neurology appointments, a sleep study, and the miserable experience of being prescribed Topamax. Ultimately, no clear medical explanation for my headaches was ever identified.

Looking back now, I can recognize something I did not fully understand at the time: I was anxious.

I was eager to please, eager to perform well, and deeply motivated to communicate, “You don’t need to worry about me — I’ve got it.” As a result, I internalized. In other words, I kept my worries to myself, often outside of my own conscious awareness.

What we now understand about anxiety is that suppressing stress, worry, or emotional discomfort does not make those feelings disappear. Instead, the body often begins to carry the burden. Emotional distress can manifest physically, especially in children who may not yet have the language or self-awareness to express what they are feeling internally.

What Anxiety Can Look Like in Children

Anxiety in children does not always look like obvious fear or panic. Often, it presents as vague or unexplained physical symptoms, including:

• Headaches

• Stomachaches, nausea, or vomiting

• Changes in appetite (eating less or overeating)

• Difficulty falling asleep

• Difficulty staying asleep

• Muscle aches or physical tension

• Fatigue (because being worried is exhausting)

• Distractibility or difficulty concentrating

  
  

Of course, not every physical symptom is rooted in anxiety, and medical concerns should always be taken seriously. If something seems off, consult your child’s pediatrician.

However, when you begin to notice patterns — headaches before school, stomachaches before social events or performances, difficulty sleeping during periods of change — it may be time to consider whether anxiety is playing a role.

Helping Children Understand the Mind-Body Connection

One of the most valuable things we can do for children is help them build emotional awareness and vocabulary.

I often explain to children that our bodies respond to our thoughts and emotions:

“Did you know that when you feel worried about something, your belly might start hurting? Isn’t that interesting?”

This helps children understand that physical symptoms can sometimes be the body’s way of signaling emotional distress. Once children understand that connection, we can begin teaching them healthy ways to cope — including talking openly about their worries rather than carrying them alone.

How to Respond When Your Child Shares a Worry

Validate and Normalize

Children feel safer opening up when they feel heard and understood.

Try:

“I’m sorry you’re feeling so worried about this. I remember feeling nervous about things like that when I was younger too.”

Avoid Dismissing the Feeling

Although it is tempting to reassure children quickly, statements like “Don’t worry about it” or "that's silly" often unintentionally communicate that their feelings are too big, irrational, or inconvenient. It does not make them stop worrying.

Address the Worry Directly

Sometimes children need information. Sometimes they need help problem-solving. And sometimes they simply need someone to sit with them in the discomfort and acknowledge that what they are feeling is hard.

Reinforce Their Vulnerability

Opening up about worries can feel risky for children. Thanking them for sharing sends an important message:

“I’m really glad you told me.”

That response reinforces emotional honesty and strengthens trust.

When to Seek Professional Support

It may be time to seek help from a mental health professional when:

• Anxiety begins interfering with daily functioning

  • Missing school or activities

  • Difficulty separating from caregivers

  • Trouble completing age-appropriate tasks independently

  • Declining academic performance

• Symptoms occur more often than not

• Your child seems stuck in cycles of distress, avoidance, or excessive reassurance-seeking

• Worry consistently feels bigger than the situation requires

  
  

Children do not always have the words to say, “I’m anxious.” Sometimes they say it through headaches, stomachaches, irritability, clinginess, or perfectionism instead.

The good news is that anxiety is highly treatable, and early support can make an enormous difference. When we help children understand their emotions rather than fear them, we give them tools they can carry for the rest of their lives.