Anxiety is Real…But So Is Manipulation (In Kids and Teens)

Let’s start with what anxiety really is.

Clinically, anxiety disorders are diagnosed by licensed mental health professionals or medical doctors—like psychologists, psychiatrists, or licensed therapists—using specific criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This diagnosis isn’t something a parent, teacher, or even well-meaning friend can hand out.

And while we’re here—let’s not forget manipulation. Manipulation in kids and teens isn’t always intentional, but it is real. It’s what happens when a child learns how to use words, emotions, or behaviors to avoid something hard or get what they want. When a child learns that saying “I have anxiety” gets them out of doing something, they’ll keep using it—because it works.

Before we go any further, let’s define what manipulation can look like in kids and teens.

It’s not always intentional or malicious. In fact, manipulation in children is often a learned behavior—when a child figures out what works to get out of something, get attention, avoid discomfort, or control the situation. It might look like sudden tears, refusing to participate, dramatic statements, or throwing out the word “anxiety” the moment something hard comes up. It’s using feelings to change the outcome, often without even realizing that’s what they’re doing. Clinically, anxiety disorders are diagnosed by licensed mental health professionals or medical doctors—like psychologists, psychiatrists, or licensed therapists—using specific criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This diagnosis isn’t something a parent, teacher, or even well-meaning friend can hand out.

I’ve seen a lot of kids and teens in the last 30 years with a true anxiety disorder. It’s real—and it can absolutely interfere with life. But I’ve also watched the term “anxiety” get thrown around so much over the years that it’s become diluted. The label is overused, and I’ve seen that increase with every generation that walks through my office.

When we were kids, we were basically taught three feelings: happy, mad, and sad—that was about it. Now the most common feelings I hear are “anxious,” “mad,” and “overwhelmed.” And guess what? That’s what kids are growing up with.

When I was a kid, we used “anxious” as if it was excitement—we were “anxious” to go to a birthday party, but our parents didn’t teach us that we had anxiety. Truly, it wasn’t a thing. While both “anxious” and “anxiety” relate to feelings of worry and unease, “anxious” describes a state of being, while “anxiety” can refer to a normal, temporary response or a persistent, debilitating disorder.

Kids today have learned the word “anxiety” from our society. There is a huge difference between feeling anxious and having a real anxiety disorder. Slapping the label “anxiety” on every uncomfortable feeling only holds kids back. And trust me, if you let your child believe they suffer from anxiety, you’ll hear about it forever. Labels stick, and kids will grab onto them as an excuse for why they “can’t” do things.

Anxiety can be taught. Kids learn it from what they hear and see at home. I’ve heard so many parents say things like, “He suffers from anxiety” — and then later in the same breath say, “He told me he can’t fold and put away his clothes because of his anxiety. He’s just too overwhelmed.” This is where the problem starts. When parents throw around the term without a true diagnosis, kids pick it up. And guess what? They’ll use it every time they don’t want to do something—whether it’s going to school, cleaning their room, doing chores, or showing up for a family gathering. It will circle back and slap you in the face.

I get so many calls from parents looking to set up appointments for their child or teen. The first thing out of their mouths? “My kid has anxiety.” And right after that come the usual complaints: they don’t want to go to school, they want to quit a sport, they’re struggling to make friends, they refuse to go to social events, or they avoid anything remotely uncomfortable. With younger kids, I hear about constant meltdowns, not wanting to leave a parent’s side, refusing to get out of the car at school, or acting out in preschool. And sometimes, kids will even throw out suicidal thoughts—not because they truly mean it, but because they know it gets a reaction. Let me be clear—real anxiety exists, but it should be diagnosed by a professional, not assumed just because a kid doesn’t want to do something hard.

Setting Your Child Up for a Lifetime of Dependence

If your child thinks they can’t function without you, that belief is going to follow them into adulthood. Anxiety and dependence go hand in hand. This happens when parents feel bad for their kid, try to shield them from every hardship, or let them avoid things that make them nervous. Before you know it, they won’t join any activities, they refuse to try anything new, and they expect you to make life easier for them at every turn.

Parents, you have to believe in your child more than they believe in themselves. Push them forward. Stop letting them control you. If you don’t, they will never believe they are capable.

What Real Anxiety Looks Like in Kids and Teens

A real anxiety disorder isn’t just a kid saying, “I’m nervous.” It’s excessive, persistent fear or worry that interferes with daily life. Here’s what professionals look for:

• Constant worry or fear that lasts at least six months and doesn’t go away.
• Avoiding social situations, school, or activities because of extreme distress.
• Physical symptoms like headaches, stomachaches, nausea, dizziness, or shortness of breath.
• Irritability, restlessness, or trouble concentrating.
• Sleep problems, including nightmares or trouble falling or staying asleep.
• Panic attacks, which can include a racing heart, sweating, shaking, or feeling like they’re losing control.

If a child meets these criteria, a mental health professional should be involved.

The Danger of Letting Anxiety Call the Shots

When parents let kids avoid things under the excuse of “anxiety,” they aren’t protecting them—they’re holding them back. Life is uncomfortable. Life is uncertain. If kids don’t learn how to handle it now, they will struggle as adults. Anxiety is real, but not every nervous feeling is a mental health crisis. Parents need to stop rearranging their lives around their child’s discomfort and start teaching them how to deal with it. Avoidance only makes things worse. Resilience is built in challenge, not in comfort.

What to Do When Anxiety Is Real

The “Even If” Technique

The “even if” technique helps kids manage anxiety by acknowledging worries while also focusing on coping strategies and problem-solving, using statements like “Even if [bad thing happens], I can [coping strategy].”

1. Understand the Technique:

• Acknowledge Fears: Validate your child’s fears and anxieties—let them know it’s okay to feel worried.
• Shift to Problem-Solving: The “even if” technique helps shift focus from the fear itself to coping and solutions.
• Structure the Statement: Use the format: “Even if [feared scenario], I can [solution or strategy].”

2. Examples of “Even If” Statements:

• Scenario: Your child is anxious about a school test.
  • Anxious Thought: “I’m going to fail the test.”
  • Even If: “Even if I don’t get everything right, I can study harder next time and learn from my mistakes.”
• Scenario: Your child is worried about a doctor’s appointment.
  • Anxious Thought: “I’m going to be really scared.”
  • Even If: “Even if I’m scared, I can take deep breaths and remember the doctor is there to help.”
• Scenario: Your child is nervous about a social event.
  • Anxious Thought: “No one will like me.”
  • Even If: “Even if I don’t make new friends, I can still have fun and enjoy myself.”

3. Tips for Using the Technique:

• Be Patient and Empathetic: Learning this strategy takes time.
• Practice Regularly: Use “even if” statements in everyday situations.
• Focus on Strengths: Help your child recognize their abilities to cope.
• Model Calm Behavior: Show them how to respond calmly to stress.
• Encourage Self-Compassion: Normalize anxiety—everyone feels it sometimes.
• Combine with Other Tools: Use alongside deep breathing, mindfulness, or grounding.
• Seek Professional Help: If anxiety is severe or persistent, get help from a licensed therapist.
• Teach coping skills: Deep breathing, grounding techniques, and positive self-talk can help.
• Seek professional help: If anxiety is getting in the way of daily life, therapy can help.
• Encourage small steps: Facing fears gradually builds confidence.

What to Do When It’s Not Anxiety

• Help them name their real feelings: Is it really anxiety, or just nervousness, embarrassment, frustration, fear, disappointment, or shyness?
• Use direct language with kids: Instead of saying, “I know you’re anxious,” try:
  • “You seem frustrated. What’s going on?”
  • “I hear you saying you’re scared. What do you think is going to happen?”
  • “You look overwhelmed. Let’s break this down into steps.”
  • “I see you’re disappointed. What were you hoping for?”
  • “You don’t want to go, but are you feeling shy or just uncomfortable?”
• Push them through it: Life is full of hard moments. Help them handle them instead of running from them.
• Stop enabling avoidance: If they’re nervous about a test, have them study. If they don’t want to go to school, send them anyway.
• Validate but don’t indulge: Acknowledge their feelings, but don’t let them dictate everything.

When to Call In Reinforcements

If you’re unsure whether your child is experiencing true anxiety or has learned to avoid discomfort by using the label, let’s talk. We can sort through the behaviors and support your child in building real resilience.