UNDERSTANDING CHILDHOOD AND ADOLESCENT ANXIETY: A GUIDE FOR PARENTS

UNDERSTANDING CHILDHOOD AND ADOLESCENT ANXIETY: A GUIDE FOR PARENTS


Commonly observed in younger children, separation anxiety involves intense fear or worry about being away from familiar surroundings, like home, or separated from loved ones. They might even experience distress simply from thinking about or anticipating separation.

This anxiety can present itself through clinginess, reluctance, or refusal to attend school/activities/sleepovers, excessive distress during drop-offs, or persistent worries about being apart from loved ones. Separation anxiety can even present itself at bedtime.

A child experiencing separation anxiety might become visibly upset, crying, or pleading for the caregiver not to leave. They may also show physical symptoms like stomachaches, headaches, or nausea when anticipating separation (sometimes several days ahead).

Additionally, they might seek constant reassurance or be overly worried about potential harm befalling themselves or their caregivers when apart. This can include fear such as caregivers being in an accident, pets dying in a housefire, or being kidnapped while playing in their backyard.

This anxiety can significantly disrupt the child’s routine, affecting their social interactions, academic performance, and overall well-being.

GAD involves excessive and persistent worries about various aspects of life, such as academic performance, social interactions, and personal safety. Children with GAD often exhibit perfectionism, excessive self-criticism, and physical symptoms like stomachaches or headaches.

These worries go beyond what is developmentally appropriate and might include concerns about minor events or catastrophic outcomes. These children may display perfectionistic tendencies, seeking constant reassurance, and overthinking even routine activities.

Physical symptoms such as headaches, stomachaches, muscle tension, or fatigue might accompany their anxious thoughts. They may struggle with falling asleep, difficulty concentrating, or irritability due to their persistent worries.

This chronic state of apprehension and heightened anxiety can impair their ability to focus in school, enjoy leisure activities, and maintain healthy relationships, impacting their overall well-being.

Children or adolescents with social anxiety experience intense fear or discomfort in social situations due to a fear of being judged or embarrassed. They may avoid social gatherings, speaking in public, or participating in activities where they feel scrutinized.

They may avoid speaking up in class, participating in activities, or attending gatherings. When forced to be in social situations, they might experience physical symptoms such as blushing, trembling, sweating, rapid heartbeat, or upset stomach.

These children often worry excessively about making mistakes, being negatively evaluated, or feeling humiliated in social settings. Their fear of rejection or criticism hampers their ability to form friendships, engage in extracurricular activities, or participate in classroom discussions, affecting their academic and social development.

Social anxiety disorder can significantly impact a child’s self-esteem, relationships, and overall quality of life.

Anxious school refusal is characterized by a persistent and overwhelming fear or anxiety related to attending school. Children experiencing this may exhibit extreme distress or panic attacks when faced with the prospect of going to school.

They might plead, cry, or express intense physical symptoms like stomachaches, headaches, dizziness, or nausea, making it challenging to leave home. Their anxiety about school can lead to frequent absences, tardiness, or reluctance to participate in school-related activities.

These children may express concerns about being separated from their caregivers, fear of social interactions, academic pressures, or experiencing bullying or ridicule at school.

The avoidance of school can significantly impact their academic progress, social relationships, and overall emotional well-being, causing distress for both the child and their family.

Specific phobias refer to intense and irrational fears of specific objects, situations, or activities. It’s important to note that fears are quite common in childhood, and many children outgrow them with time.

However, when these fears persist beyond normal developmentally appropriate worries and significantly interfere with a child’s daily life, it may be indicative of a specific phobia. Common phobias include fear of dogs, insects, spiders, the dark, thunderstorm, needles, vomiting and costumes.

A panic attack is characterized by a sudden and intense surge of fear or discomfort that reaches its peak within minutes. The onset is unexpected without obvious triggers.

In children, panic attacks can be mistaken for intense meltdowns. Physical symptoms might include racing heart, shortness of breath, chest pain or discomfort, trembling, sweating. The child might also be unable to speak or respond.


  • Temperament: Inherent behavioral traits can predispose children to anxiety. Highly reactive or shy temperaments may increase vulnerability to anxiety disorders. Children exhibiting behavioral inhibition, heightened sensitivity to new stimuli, or excessive shyness might be at a higher risk of developing anxiety-related challenges.
  • Parental Anxiety: Children of parents with anxiety disorders might be more susceptible to developing anxiety themselves. This can be due to genetic predisposition or learned behaviors and coping mechanisms observed at home.
  • Biological Factors: Imbalances in brain chemistry or alterations in brain function can contribute to anxiety disorders. Genetic predisposition and neurological differences may increase a child’s vulnerability to anxiety.
  • Environmental Factors: Stressful life events, such as family conflicts, major life changes, parental divorce, or moving to a new environment, can trigger or exacerbate anxiety symptoms in children.
  • Trauma and Stress: Exposure to traumatic events, such as abuse, neglect, or accidents, can significantly impact a child’s mental health, leading to the development of anxiety disorders.
  • Open Communication: Encourage open conversations with your child about their feelings and emotions. Create a safe and non-judgmental environment where they feel comfortable expressing their worries.
  • Validate Feelings: Acknowledge and validate your child’s emotions. Let them know that it’s okay to feel anxious and that you’re there to support them.
  • Parental accommodations: Refers to the adjustments or modifications that parents make in their behavior or routines to accommodate their child’s anxiety symptoms. For example, parents may avoid certain situations or activities that trigger their child’s anxiety. While this might provide temporary relief, it reinforces the idea that avoiding anxiety-provoking situations is the only solution.
  • Promote Healthy Coping Mechanisms: Teach your child healthy coping strategies like deep breathing exercises, mindfulness, regular physical activity, and relaxation techniques to manage their anxiety.
  • Establish Consistent Routines: Structure and predictability can be comforting for anxious children. Establishing regular routines for meals, sleep, and activities can help reduce anxiety levels.

If you are concerned about your child’s anxiety, consider seeking help from a mental health professional, such as a therapist or psychologist, specialized in treating children and adolescents.

Explore online child psychotherapy services and online adolescent psychotherapy services at the Leon Psychology Clinic. Our psychologists and psychotherapists can help determine whether your child’s symptoms are within the range of typical development and, if required, provide support and intervention for an anxiety disorder.


  • ”Ruby Finds a Worry” by Tom Percival
  • ”How Big Are Your Worries Little Bear” by Jayneen Sanders

Anxiety in children can manifest in various ways, and it’s important to note that each child is unique, so symptoms may vary. Additionally, some level of anxiety is normal and can be part of typical development. However, when anxiety becomes excessive or interferes with a child’s daily functioning, it may be a cause for concern. Here are some common signs and behaviors that may indicate anxiety in children: stomachaches, headaches, muscle aches, avoidance, clinginess, irritability, restlessness, regression (ex., bedwetting), sleep difficulties, social withdrawal, school difficulties, and more.

Anxiety can manifest at any age, including infancy. However, the presentation of anxiety symptoms may vary depending on developmental stages. It’s normal for children to experience anxiety in response to new experiences, such as starting school or meeting new people. Transient anxiety is a typical part of development, and many children naturally outgrow specific fears and worries. In terms of more persistent anxiety disorders, some may emerge in early childhood, while others may become more noticeable as a child grows older.

Research suggests that many children with anxiety have a parent with anxiety. This is because of a combination of biological factors (shared genes) and environmental factors (modelling anxiety and ineffective coping, overprotective parenting).


As a parent, it’s crucial to understand that childhood and adolescent anxiety disorders are treatable conditions. With early recognition, support, and appropriate interventions, children and adolescents can learn to manage their anxiety effectively, leading to improved well-being and a more fulfilling childhood experience. Your empathy, understanding, and proactive approach can make a significant difference in your child’s mental health journey.

Dr. Stephanie Leon

Dr. Leon is a clinical psychologist and neuropsychologist practicing in the province of Ontario and Quebec. She works with children, teens, and their parents to address emotional, behavioural, and cognitive difficulties. Dr. Leon provides online psychology services through the Leon Psychology Clinic.

PERFECTIONISM: SIGNS, RISKS, & STRATEGIES TO COPE

PERFECTIONISM: SIGNS, RISKS, & STRATEGIES TO COPE

“I’m not a perfectionist. If I waited for perfection, I would never write a word.” – Margaret Atwood

We can all agree that issues like depression or anxiety are problematic. But perfection is trickier—mainly because so many people seem to achieve it all around us every day. 

If you’re like most people, you spend hours each day scrolling through curated snapshots of people’s most perfectly curated moments. It makes you wonder: perfectionist tendencies can’t really be so terrible for you, can they? Actually, they can. 

Let’s get clear on what perfectionism is, how you can spot it, and what you can do to address it. Here’s what you need to know. 

What Is Perfectionism?

Perfectionism is a personality trait that goes beyond setting high standards for oneself; it’s an intense drive to meet these standards, often tying one’s self-worth to them. And while many conflate perfection with excellence, there’s a stark difference between the two. 

Excellence is a commendable pursuit of being above average, fostering personal growth. Conversely, perfectionism sets the bar so high that anything less than perfect becomes intolerable, even breeding feelings of inferiority or self-loathing. 

There are three subtypes of perfectionism. 

1) Self-Oriented Perfectionism

Self-oriented perfectionism is best understood as an internal pressure to be flawless. Those who exhibit this trait set sky-high standards for themselves accompanied by a severe sense of self-criticism and negative self-talk. 

Failing to meet personal standards, especially in critical situations, can lead to a barrage of self-deprecating thoughts like, “What were you thinking, you idiot?” or “How could you make such a mistake? You’re a failure!” 

A striking example of self-oriented perfectionism at work was during the 2008 Miami Open. In a moment of intense self-frustration, competitor Mikhail Youzhny hit himself violently with his racquet after missing a shot. 

2) Socially Prescribed Perfectionism

Socially prescribed perfectionism stems from the belief that society expects you to be flawless. These perfectionists are likely to experience daily feelings of inferiority, shame, and resentment. 

One study highlights a 40% increase in socially prescribed perfectionism since the 1980s, particularly among young adults. This is no doubt thanks to the unyielding barrage of “perfect” lives on social media coupled with mounting pressures to achieve in work and school. 

Socially prescribed perfectionism is particularly alarming due to its strong correlation with negative mental health conditions, such as depression and anxiety.

3) Other-Oriented Perfectionism

Other-oriented perfectionism involves projecting one’s own perfectionistic tendencies onto others. A classic example is what’s commonly referred to as tiger parenting, where parents set exceedingly high expectations for their children. 

People with this trait can be outspoken about their expectations and quick to point out when things deviate from their envisioned plan. It’s akin to what Freud described as “projection,” where one’s internal drive for perfection is externalized. 

A notable figure often associated with this trait is Steve Jobs, whose impossible standards were not just for himself but also for those around him.

What Are The Signs of Perfectionism?

While often masked as a commendable trait, perfectionism can manifest in various behaviors that might hinder personal growth and well-being. Recognizing these perfectionist habits is the first step towards understanding and managing this complex trait. 

  • Procrastination – Delaying tasks for fear of not achieving perfection and then spending excessive time on the task once started. 
  • Difficulty Recognizing When To Stop – Continuously adjusting or redoing tasks in pursuit of the “perfect” result.
  • Avoidance – Avoiding new experiences or challenges due to fear of not being perfect.
  • Overreaction To Mistakes – Magnifying the significance of errors, leading to excessive self-criticism or guilt.
  • Not Giving Your Best Effort – Withholding effort in challenging situations to protect one’s image.
  • Excessive Self-Criticism – Harshly judging oneself for not meeting high standards.
  • High Sensitivity To Criticism – Perceiving feedback or constructive criticism as a personal attack.
  • All-Or-Nothing Thinking – Viewing situations in black and white, with no middle ground.

Procrastination

One of the paradoxical signs of perfectionist thinking is procrastination. While perfectionists are often seen as diligent and hardworking, the intense fear of not meeting their own high standards can lead them to delay or even avoid tasks. 

This avoidance is not due to laziness but rather an overwhelming fear of potential failure or criticism.

Avoidance 

The fear of imperfection can be so intense that it deters perfectionists from trying new things altogether. They might avoid new experiences, tasks, or challenges because the uncertainty of the outcome feels threatening. 

Overreaction to Mistakes

Everyone makes mistakes, but even minor errors can feel catastrophic for perfectionists. They tend to magnify the significance of their mistakes, leading to excessive self-criticism, guilt, and even shame. This heightened sensitivity can hinder their ability to bounce back from setbacks.

What Are The Risks Of Perfectionism?

Literature and cinema have long highlighted the risks of unchecked perfectionism. Just look at Gatsby’s obsession with an idealized past or the haunting narratives of films like “Black Swan” and “The Prestige,” and you’ll see that perfectionist thinking comes with an immense cost. 

Some documented risks of perfectionism include: 

  • Damaged Self-Esteem – Continually failing to meet one’s own lofty and unrealistic expectations can chip away at one’s self-esteem. Perfectionists often experience large fluctuations in self-esteem tied to their perceived sense of accomplishment. 
  • Frequent Frustration – The constant chase for perfection often leads to recurring feelings of disappointment and frustration. Rarely do perfectionists feel good about their accomplishments.
  • Poor Performance – The paralyzing fear of imperfection can result in avoiding tasks, leading to extreme procrastination and, eventually, poor work or school performance. Avoidance can also show up in other areas of performance such as in athletes, parental roles, and relationships.
  • Diminishing Productivity – Ironically, while perfectionists are known for their hard work, they often push themselves to the brink of diminishing returns. Their lives can feel like an endless race on a relentless treadmill.
  • Depression & Anxiety – One study focused on college students demonstrated that both adaptive and maladaptive forms of perfectionism are linked to increased symptoms of depression and anxiety. The act of rumination, or continuously mulling over distress, was identified as a significant factor in this relationship.

How To Overcome Perfectionism?

Overcoming perfectionism isn’t just about letting go; it’s about embracing a new way of thinking. Here are some tips for addressing perfectionism head-on. 

  1. Awareness Of Procrastination 

Identifying procrastination patterns is the first step to addressing underlying fears and taking proactive steps to move forward. Try to recognize when you’re delaying tasks out of fear of imperfection. 

  1. Monitoring Your Critical Voice

Tune into your inner dialogue. If you find yourself constantly self-criticizing or setting unrealistic standards, challenge those thoughts. Replace them with more balanced and compassionate self-talk. Try a mantra like, “everybody makes mistakes, I’m no different.” 

  1. Tolerating Mistakes

Understand that mistakes are a natural part of growth and learning. Instead of dwelling on errors, focus on the lessons they offer. Accept failures as stepping stones to success. Over time, you’ll retrain your brain to have a growth mindset rather than an all-or-nothing mindset. 

  1. Engaging In Self-Care

Perfectionists are notorious for working late nights, skipping meals, and putting their basic needs aside to achieve their goals. Whether it’s taking breaks, engaging in hobbies, or simply getting adequate sleep, combat the stresses of perfectionism by making time for self-care. 

  1. Embracing Mindfulness

Focusing on the ‘now’ lets you let go of past mistakes and future anxieties, allowing you to approach tasks with a clear mind. Mindfulness practices, such as meditation and deep breathing exercises, can help ground you in the present moment and let go of the fear of failure. 

Does Psychotherapy Help Treat Perfectionism?

Psychotherapy is a valuable tool in addressing and managing perfectionistic tendencies. If you or a loved one is experiencing the debilitating effects of perfectionism, here are two forms of psychotherapy that may be able to help. 

Cognitive-Behavioral Therapy (CBT) 

CBT helps individuals identify the patterns of their perfectionistic thoughts, beliefs, and behaviors. Once these patterns are recognized, CBT techniques assist in challenging and reframing these often irrational beliefs. 

For instance, the belief that “anything less than perfect is a failure” can be restructured to “doing my best is good enough.”

CBT also introduces behavioral strategies to break the cycle of perfectionistic actions. This might include setting realistic goals, practicing self-compassion, or confronting rather than avoiding tasks that trigger perfectionistic tendencies.

Family Therapy 

Perfectionism in young people can sometimes have its roots in family dynamics. Family therapy delves into these origins, exploring patterns, expectations, and interactions that might contribute to an individual’s perfectionistic behaviors.

This collective approach ensures that the family becomes a supportive environment, promoting healthier beliefs and behaviors. Family therapy can also equip family members with communication tools to express their expectations in more constructive ways, reducing pressures that might feed into perfectionistic tendencies.

Through Leon Psychology Clinic’s virtual psychotherapy services, our clinical psychologists can work together to unravel the layers of perfectionism. You can access perfectionism therapy with licensed mental health professionals from the comfort of your home with the convenience of fully virtual sessions. 

Explore online adult psychotherapy services and online adolescent psychotherapy services and start your journey toward overcoming perfectionism today. 

Frequently Asked Questions

What is the difference between OCD and perfectionism? 

While both Obsessive-Compulsive Disorder (OCD) and perfectionism involve intense desires for order and precision, they stem from different motivations and manifest differently:

  • OCD is a mental health disorder characterized by unwanted repetitive thoughts (obsessions) and behaviors (compulsions) that individuals feel driven to perform. The compulsions are often carried out to alleviate the distress caused by the obsessions. For example, someone with OCD might repeatedly check if the door is locked due to an irrational fear of a break-in.
  • Perfectionism, on the other hand, is a personality trait where individuals set excessively high standards for themselves. The drive to achieve these standards is often tied to their self-esteem. A perfectionist might re-read an email multiple times before sending to ensure it’s “just right,” not necessarily due to a specific fear but because they want it to be perfect.

What are the signs and symptoms of a perfectionist? 

Perfectionists often exhibit a range of behaviors and thought patterns, including:

  • Procrastination: Delaying tasks due to fear of not doing them perfectly.
  • Reluctance to Delegate: Believing that only they can do tasks to the required standard.
  • High Sensitivity to Criticism: Taking feedback personally or viewing it as a direct attack on their abilities.
  • All-or-Nothing Thinking: Viewing situations in black and white, with no middle ground.
  • Excessive Self-Criticism: Engaging in harsh self-judgment when standards aren’t met.
  • Avoidance: Steering clear of new challenges or experiences due to fear of not being perfect.

Are there any helpful affirmations for perfectionists? 

Affirmations can be a powerful tool for reshaping thought patterns. Here are some affirmations tailored for perfectionists:

  • “I am enough just as I am.”
  • “Progress is more important than perfection.”
  • “I release the need for approval and embrace my authentic self.”
  • “Mistakes are a natural part of growth and learning.”
  • “I am worthy of love and acceptance, regardless of my achievements.”
  • “I choose to focus on my strengths and celebrate my victories, no matter how small.”
  • “Perfection is not the path to happiness; being true to myself is.”

Can children and adolescents show perfectionism traits too? 

Yes. Perfectionism can start early but is usually most recognizable in pre-teen and teenage years. Children and teens with parents who have perfectionistic traits themselves or who are very focused on performance (usually academic or in sports) are most likely to develop and show these traits early.

Perfectionism can lead to increased stress, anxiety, and a fear of failure, impacting mental well-being and hindering productivity. Seeking support through therapy, practicing self-compassion, and setting realistic goals rather than pursuing flawless outcomes can help manage perfectionism, fostering a healthier mindset and promoting personal growth.

dr. stephanie leon online child psychologist neuropsychologist in ontario quebec

Dr. Stephanie Leon

Dr. Leon is a clinical psychologist and neuropsychologist practicing in the province of Ontario and Quebec. She works with children, teens, and their parents to address emotional, behavioural, and cognitive difficulties. Dr. Leon offers online psychology services through the Leon Psychology Clinic.

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