~Hyperactive child? It may be anxiety~

This is for parents and caregivers who may be struggling with what to do (the updated version since the author is a therapy geek;).

Hyperactivity in children can be extremely exhausting for their parents, siblings, family, teachers, and other caregivers. Hyperactivity generally presents as overly active behavior that is not controllable by the child. Discipline is typically not effective with controlling it. Some symptoms include being overly active, talking fast, interrupting others, inappropriate behaviors, having unlimited amounts of energy, insomnia, waking up early, being loud, having a “poor filter,” and impulsive behaviors.

Hyperactive behaviors frequently have consequences in the academic setting, with peers, in the home environment, and in the child’s sense of self worth. For example in younger children, a child may be asked to leave a childcare center because of the disruption in a classroom. In older children, hyperactive behaviors may result in multiple disciplinary actions that impact academic success. Peers may have difficulty relating or even bully a child that is “acting different.” In the home environment, these behaviors may be difficult to control, frustrating, and viewed by guardians as manipulative or attention seeking. What is frequency not understood, is that hyperactivity is generally quite uncomfortable, embarrassing, and uncontrollable for a child. And the negative feedback from caregivers and peers can create a low self esteem.

But here is something that many people are not aware of. Hyperactivity is often a symptom of anxiety in children. Anxiety presents very differently in children than adults, as does depression. In fact many children that present with “impulsive and hyperactive behaviors” are actually extremely anxious. So what does anxiety look like in Children? Symptoms include but are not limited to: a low self esteem, irritability, being hyper focused on video games or specific toys for comfort, thumb sucking, nail biting, skin picking, fighting with siblings or peers, impulsive behaviors, inappropriate behaviors, hyperactivity, hair pulling, self harming, being fidgety, insomnia or difficulty sleeping, difficulty making friends, difficulty making decisions, difficulty in overstimulating environments (such as in a grocery store), difficulty holding conversations with peers or extended family, being overly needy, worrying excessively, checking up on a parent or guardian repeatedly, worrying about catastrophic issues, somatic symptoms (such as tinnitus, headaches, & GI issues), and many more.


Hyperactivity and Anxiety can be difficult to distinguish from one another. Yet a Mental Health Professional can assist the caregiver in figuring out what is occurring. There are also other issues that can mimic the same symptoms, but that will not be discussed in this article. Essentially if a Mental Health Professional is deciding between Attention Deficit Hyperactivity Disorder (ADHD) and an Anxiety Disorder in a child, hyperactive behaviors will be only one of many symptoms in an anxiety disorder.

If you suspect your child has symptoms of anxiety, try to figure out what helps comfort and calm your child at home and school . And no, not social media. For example, if they seem calmer in a quiet environment perhaps invest in a white noise machine. Have their comfort items easily available. Talk to them about anxiety and how it’s normal. Educate them on stress and the body. Turn the news and social media off when they are up. Try to not discuss adult topics in front of your children, unless needed. A structured and stable environment at home and school is extremely important to decrease anxiety. One suggestion is to have a calendar that your child can see so that they know what to expect. Teachers can assist children with anxiety by giving them advanced notice of assignments, accommodations to help decrease anxiety episodes (such as a book to read), and preferential seating.

Anxiety is fairly treatable in children with the appropriate therapist and other treatment providers. Sometimes schools need to make accommodations to meet your child’s needs. Therapy is recommended as a first line of treatment, especially with a therapist who works well with children. Play Therapy is often required as a form of counseling. In addition, sometimes medication is recommended for sleep disruption or to help create a sense of calm. This is best assessed and treated by a Child Psychiatrist.

I hope you find this helpful. It’s something I have wanted to write for a long time. And definitely a relevant issue. Any suggestions or thoughts to add are appreciated.

Angie Simonton, LCSW-BACS

Written on 01/16/18/ Updated on 01/21/18.