Parents are no strangers to children’s stomachaches, which always seem to pop up at the most inopportune times: right before the big performance or the championship game, or while the whole family packs for an exciting trip to Disney. But often that inconvenience isn’t just the stomach acting up—and your kid probably isn’t faking the pain, either. Anxiety frequently causes nausea, especially in children who struggle to understand their nervousness.
Nausea and anxiety have long been bedmates, although we haven’t always understood the link. A landmark 2002 Norwegian study found that 48% of people who complained of gastrointestinal distress had either anxiety or depression. (There’s some debate, however, about in which direction this link occurs.) Many researchers link the phenomenon of anxious stomach upset to the gut-brain connection.
Why Does Anxiety Cause Nausea?
Your gut and your brain are always talking. Thinking about eating? Your stomach might prime itself for food, all thanks to the enteric nervous system, which helps maintain your gut biome. Similarly, your anxiety might kickstart a sick, queasy sensation. There’s a reason throwing up in the wings is a common symptom of stage fright—as are those first-day-of-school tummy aches.
Anxiety is far from a purely psychological experience. It can have a profound impact on your body. If you’ve ever had a panic attack, or even a really bad bout of nerves, you’re probably familiar with the sensation. An activated stress response can cause everything from an increased heart rate and rapid breathing to muscle tension and, yes, changes in your digestion. Anxiety triggers your fight-or-flight response, priming your body to respond to perceived threats.
Nerve-induced nausea might range from mild discomfort to full-blown vomiting, which can have a significant impact on your child’s well-being and functioning.
You might also find that anxiety-induced nausea happens more frequently in the morning. That’s especially common for school-aged children. In fact, it’s pretty common for people of all ages—starting your day can be scary! Your kid might be anxious about an exam or presentation at school that day, or maybe even they’re nervous due to tension in their friend group. Talking with them about their upcoming day can help identify the reason they’re feeling queasy.
Understanding Somatic Nausea
Somatic nausea is another way to refer to the sometimes surprising intrusion of mental experiences on your physical body. Anxiety and other mental health issues create complex emotional and physiological responses that weave together mind and body. When a child experiences nervousness or anxiety, their thoughts, emotions, and physical sensations can become intrinsically intertwined. This is caused when their body activates the stress response system, which triggers physiological changes that disrupt your digestive system.
Additionally, the release of cortisol—a common stress hormone—can have major effects on the digestive system. This can decrease your gastric motility, a.k.a. the movement of food through the stomach and intestines. Slowed-down digestion might also increase your likelihood of becoming nauseous.
What Anxiety Disorders Cause Nausea?
Anything that makes you anxious can lead to nausea. But if you’re dealing with a kid with a tummy ache, pinpointing the cause may be difficult. Of course, it could just be garden variety nerves—starting at a new school is scary!—or it could be a more serious disorder that might require therapy, medication, or other interventions. Common anxiety disorders that may cause nausea include:
- Generalized anxiety disorder (GAD): Children with GAD might experience excessive worry and anxiety about all sorts of things—from school to friends and family.
- Social anxiety disorder (SAD): This disorder is characterized by a serious fear of social situations and a worry about being judged or feeling embarrassed. SAD might be particularly triggered by an impending social event or interactions.
- Panic disorder: Recurrent panic attacks may indicate your child suffers from panic disorder. These attacks can involve a sudden, overwhelming feeling of fear or impending doom, and can involve a range of physical symptoms, including lightheadedness, a fast heartbeat, or nausea and vomiting.
- Phobias: These intense, disproportionate fears center around specific objects or situations (for example, a crippling fear of dogs or a fear of the dark).
- Separation anxiety disorder: Separation anxiety disorder can cause excessive fear or distress when your child is separated from their primary caregiver. One example: Is your child frequently going to the nurse with stomach troubles in order to be reunited with you? They may be suffering from separation anxiety.
Understanding the specific anxiety issues your child might be suffering from can be crucial to addressing the symptoms—but remember, anxiety does not always come alongside a specified disorder (and nausea doesn’t always mean anxiety). If your child is frequently experiencing nausea, a visit with their pediatrician and a consultation with a licensed therapist may be in order.
Anxious Nausea Symptoms to Watch For
Is your child nauseous, but you aren’t sure whether the nausea is due to anxiety or a physical illness? There are a number of other signs to look out for, both biological and behavioral. Unfortunately, the first set of signs tends to overlap with physical illnesses—so it’s always best to consult a doctor.
Physiological signs associated with anxiety-induced nausea
These are common physical manifestations that help determine if nausea in your children is due to anxiety:
- Pale complexion: Your child’s face may seem pale and ashen.
- Increased sweating: Heightened anxiety can cause sweating, even when the room is cold.
- Fast heartbeat: Anxiety triggers the stress response, which can cause an elevated heart rate.
- Shallow breathing: An increase in stress levels may cause rapid breathing patterns or for your child to breathe more shallowly.
Behavioral signs associated with anxiety-induced nausea
If your kid exhibits these signs, it might be an important clue that their stomach aches because they’re anxious, stressed, nervous, or scared—not necessarily because they’re ill.
- Avoidance: Your child avoids certain situations, places, or activities, like their school, a playground, daycare, or sports practice. It’s possible a situation or location caused them anxiety in the past and they’re now seeking to steer clear of that stressor.
- Irritability: Does your child seem tetchier than usual? When paired with nausea, mood swings and heightened irritability can point toward anxiety.
- Trouble concentrating: Thinking can be hard when you’re stressed out! Anxiety—plus the nausea that accompanies it—makes it hard for kids to focus on tasks or pay attention in school or at home.
- Withdrawal or isolation: There’s nothing wrong with being independent, but if a former social butterfly is withdrawing socially, they may be experiencing anxiety.
One important note: The presence (or lack) of these signs doesn’t confirm and exclude anxiety-induced nausea. Many other medical conditions or psychological factors could cause similar symptoms. If you think your child is dealing with anxiety, don’t skip meeting with a doctor and mental health specialist for a comprehensive consultation and evaluation.
How to Stop Nausea Caused by Anxiety
As a parent, it’s understandable if your first reaction to your child’s anxiety-induced nausea is to remove whatever’s causing the pain. But you, and your child, can’t avoid anxiety triggers forever, and it’s best to teach your child how to handle their nerves in a healthy manner.
First, there is one big thing you can do as a parent: Create a calm, supportive environment. Here are some strategies to consider when trying to help ease your child’s anxiety and nausea:
- Encourage open communication: Create a safe space for your child, and allow them to express feelings and concerns without judgment. Even simply determining the issue that is making them anxious can help a child begin to feel better.
- Provide reassurance: Make sure children know that their feelings are valid, and you’re there to support them. Offer words of comfort and let them know that anxiety is common and manageable.
- Lean into predictability and routine: A consistent daily routine can provide stability and predictability for your child. Knowing what to expect every day can help manage anxiety.
It’s also important to work with them on developing strong coping methods for dealing with their anxious feelings. Managing children’s nerves can also help relax the body and decrease associated nausea. Here are some techniques to help them practice:
- Deep breathing: Encourage your child to take slow, deep breaths in through their nose, then hold for a few seconds. Last, exhale slowly through the mouth.
- Progressive muscle relaxation: Systematically tense and relax muscle groups, from eyes to the tip of the toes.
- Mindfulness and meditation: Meditation promotes present-moment awareness. It can help reduce stress and make your child feel more calm. There are several apps and online resources that can teach mindfulness in a way that’s accessible to children.
Sometimes, though, no matter what you try, the anxiety nausea doesn’t stop. Additionally, after an experience of vomiting, some children develop a fear of vomiting, i.e., their expression of feeling nauseated is actually a hypersensitivity to and anxiety about the possibility of vomiting again. Childhood anxiety and nausea can be a vicious cycle and if it persists—or is significantly impacting your child’s day-to-day functioning—it’s time to seek professional help.
A healthcare professional, like your child’s pediatrician, can evaluate their overall symptoms. They’ll look for any physical explanations for the persistent nausea, and can also provide input on psychological concerns, too.
Your physician may also recommend therapy with a licensed mental health professional. There are a number of evidence-based practices, including cognitive behavioral therapy or CBT, that can help treat anxiety disorders. These approaches will help your child identify and challenge their intrusive negative thoughts, practice coping skills, face their fears, and manage their anxiety-related symptoms—including nausea.
Learning to tell if a child’s nausea is due to anxiety can also help you recognize when it is time to seek help, and fortunately, there are proven treatments available to manage the condition. To get help for a child with nausea from anxiety, start with a free consultation from a licensed Handspring Health therapist today.