A child looks distressed

Family Health

How to Know If Fear Is Just Childhood Development or a Mental Health Concern

Jan 18, 2019

These days, children often have the vocabulary of an adult and sometimes may have amassed many facts from just watching YouTube or reading about just about anything on the internet.

Many adults may then surmise that children are more capable in managing their lives than they really are. In the last century, thanks to psychological and neuropsychological research, we know much more about the ways in which children’s brains differ from adults or even adolescents, hence how thinking, feeling and behaviour change as we age and mature.

In fact, we now know a lot more about what to expect and not to expect from children, what is normal childhood behaviour and what might be a clinical problem. But for many adults, it isn't always easy to discern one from the other. 

For example, anxiety is an emotion that is common across all ages. It is the emotion that warns us about possible threats and dangers and keeps us safe. And there are many normal childhood anxieties. 

Stranger Anxiety

Between the ages of six months to three years, many children experience and express stranger anxiety.

One of the first things children pay attention to in controlled studies is faces. This is so they can identify their caregivers. An infant is more interested in those who will take care of them and less interested in those who might be indifferent. This makes a lot of sense when you’re vulnerable and dependent. Children usually outgrow this fear and expand their comfort zone through learning that many adults are kind and may even be somewhat interested in their well-being. They also learn it through modelling. The caregiver adult shows the child that this person is safe and should be included in the safe zone.

When to seek help or guidance:

If this behaviour persists past age four, it is less common and might be a precursor to more clinical problems.

Relevant Reading: Strategies for Parenting Kids with Anxiety

Separation Anxiety

From toddler age until five or six, many children experience separation anxiety. Again, thinking about their own safety and survival, children prefer what is known to what is unknown. Sometimes they view the beginning of school, or a change in day care, as being thrown into a new and unknown environment. If parents and staff model appropriate brave behaviour, they soon learn that the new environment is a safe one.

When to seek help or guidance:

If separation anxiety persists after a month or two, it is possible that there is actually something unsafe happening, such as aggressive behaviour on the part of another child or children, or in rare cases from the adult, which would need to be addressed. If it persists through later childhood or even adolescence, it is likely a more serious problem — possibly the individual is having trouble adapting to changes in general, which could suggest a more pervasive problem that needs professional attention.

Relevant Reading: 6 Ways You Can Build Your Child's Self-Esteem


Beyond anxieties, children also experience another common feeling: fear.

Once a child’s imagination develops, which can be as young as age two, all kinds of fears can pop up and this is very normal. That's because children don’t understand the difference between what’s real and what’s imaginary as well as adults do. 

Some normal fears, to name a few: monsters; the dark; large, threatening objects; bees; swimming pools; thunderstorms and other loud noises; escalators; bad guys; and clowns.  By the time a child reaches elementary school, this list of fears expands to rational fears, such as fear of the real dangers of the world, like natural disasters (fires and tornadoes) and traumatic events caused by other people (being kidnapped, robbed or assaulted). 

The ultimate fear, which is also shared by most adults is death or critical illness. Children are also fearful of being mistreated by other children and/or adults, or being excluded and rejected, as well as family conflicts and separations. All of these fears are rational — that is to say they make sense, and they are normal. 

When to seek help or guidance:

If, however, they become so pervasive that the child begins to avoid normal and expected activities, such as school and social events, then they are out of line and need to be addressed.

Remember: Self-Control Takes Time

We expect babies to cry because they have no other way of communicating. But children cry too, even when they have the ability to speak. We now know that self-control comes when the higher-order areas of the brain develop, such as the prefrontal lobe. But that development occurs slowly and is not fully complete until a person is in their mid-20s. This development allows a person to stop and reflect for a moment or two about the right course of action to take in any particular situation. 

Children, in general, don’t do this kind of reflection as much as adults do and therefore often make wrong choices about behaviour. Where an adult might stop and say to themself, “Gee, I can’t think straight. I feel exhausted. I’ve got a lot going on. I think I’m in overload. I probably need to take a break. I think I might go to bed early tonight and hopefully feel better in the morning,” a child will rarely if ever talk to themselves that way. When a child is in overload — too many things hitting them all at once, or something unexpected and negative happening and catching them off-guard — they might have a meltdown, cry, or even lash out in anger at someone near them. Since the brain has not completed the circuits connecting the primitive parts of the brain to the more advanced, the entire brain gets activated and you never know what’s going to come out. 

This is entirely normal during childhood when all the different parts of the brain have not yet learned how to work with one another. With an adult’s help during childhood, a child can practice making the proper connections to the higher levels of thinking in the frontal lobe and learn how to make their brain work in a more mature and rational way. This doesn’t happen overnight and requires a lot of practice. But with patience and determination, it will eventually become a learned response. Ah, peace at last!

Article Author Dr. Robin Alter
Dr. Robin Alter

Read more from Dr. Robin Alter here.

Dr. Robin Alter is a trustee with The Psychology Foundation of Canada and chair of their Kids Have Stress Too Program. Dr. Alter co-led the development of this ground-breaking program targeted to parents, raising awareness that children do experience stress and providing parents and caregivers with the tools to help their children identify and manage stress. Dr. Alter is a registered clinical psychologist in practice since 1979. Her current practice includes both the assessment and treatment of children, adolescents and adults. She consults to Blue Hills Child and Family Centre since 1980.  She has authored two books: Anxiety and the Gift of Imagination and The Anxiety Workbook for Kids. Follow The Psychology Foundation on Twitter, Instagram and Facebook and to access Kids Have Stress Too! resources.

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