Anxiety is an increasingly common problem among children and young people, with approximately 1 in 10 people experiencing it at some point in their lives. Some level of anxiety is common to everyone. We only consider anxiety a disorder when it starts to have a significant impact on a person's day to day life and/or leads to a significant amount of distress. There are many different types of anxiety disorders and they all affect how children and young people think, feel and behave. Some are more common in young children and others in adolescents but they can all occur at any age. Often, there’s no one single cause of anxiety. A range of different factors can contribute, such as genetic factors and stressful life events. Anxiety can fluctuate over time and at times of stress, such as family separations, school transitions and exam periods.
The most common types of anxiety are:
Social anxiety disorder is an anxiety relating to embarrassing oneself or being judged negatively by others. This can make certain situations at school particularly difficult, for example group work, performance situations and asking for help.
Generalised anxiety is worrying excessively about a range of different issues, which are difficult to control. GAD is often accompanied with unpleasant physical symptoms.
Separation anxiety relates to difficulties being apart from a parent or carer, resulting from fear that if they?re separated, something bad might happen to them or their parent. These fears can make school attendance particularly difficult.
Panic is intense feelings of anxiety with prominent physical symptoms, such as difficulty breathing, chest pains, sweating and tingling. Panic attacks can have a specific trigger or come out of nowhere. Once a panic attack has occurred, it?s usual to have an intense fear of future panic attacks.
Specific phobia is an excessive fear of a particular place, object or situation that significantly interferes with a child or young person?s life, for example, needles (injections), spiders or certain animals.
Obsessions and compulsions
Obsessions are intrusive/repetitive thoughts or images�usually followed by an urge to act in a certain way in response to these thoughts. The specific behaviours, rituals and/or routines that follow are known as compulsions. Children and young people feel uncomfortable or anxious when unable to complete them.
Anxiety disorders can have physical, psychological and behavioural symptoms that can vary between each individual.
The most common symptoms are:
Increased heart rate, headaches, nausea, vomiting, sweating, restlessness, dizziness, muscle tension, shaking, tingling and difficulty breathing.
A tendency to overestimate the severity and likelihood of something bad happening and underestimate their ability to cope. For example: ?I?m going to forget my presentation, everyone will laugh at me and I won?t know what to do.? Unhelpful thinking styles such as catastrophising, mind-reading and predicting the future are also symptoms.
It?s common for children and young people with anxiety to avoid situations/activities that they find anxiety provoking, e.g. group tasks, presentations and injections.
Anxiety can manifest in different ways depending on the individual and anxiety disorder. It?s therefore sometimes difficult to identify.
Some of the difficulties anxiety can cause are:
- Difficulty concentrating and focusing
- Poor memory
- Avoiding certain situations, tasks or activities
- Restlessness, agitation and difficulty staying settled
- Complaining of physical symptoms
- Having difficulties joining in with certain tasks and activities
- Outbursts of anger or crying
- Increased irritability, mood swings and stress
- Avoiding socialising with family and friends and/or avoiding taking part in social events with family/friends
Breathing slowly is one of the most helpful skills when you?re experiencing anxiety. Try using a count of 3-in, 1-hold, 4-out to start off. Breathe into your belly rather than into your chest. This will help the body calm down quickly. Try practising this daily.
The 5, 4, 3, 2, 1 method is a calming technique that can be helpful to use in a stressful situation or when there is an increase in symptoms of anxiety. This technique involves using the five senses in the following way:
- Start by slowly breathing in and out
- SEE:�look around for�5�things you can�see�and say them out aloud. For example, you could say, I see the television, I see the mug or I see the yellow car outside
- TOUCH:�think of�4�things you can�feel�and say them out aloud. For example, you could say, I feel the woolly socks on my feet, I feel the sunshine on my back, or I feel the wooden chair I am sitting on
- SOUNDS:�listen for�3�sounds that you can�hear�and say them aloud. This could be the sound of the birds tweeting outside, the music on the radio or the cars driving past
- SMELL:�think of�2�things you can�smell. If you can?t smell anything, then you can think of two of your favourite smells, such as freshly baked cookies or your favourite perfume/aftershave
- TASTE:�think of�1�thing you can�taste�and say it out aloud. If you can?t taste anything, you can say some of your favourite tastes, such as chocolate or mints
- Finish by slowly breathing in and out
Avoidance of fears in the short term can reduce symptoms of anxiety. However, in the long-term, it can contribute to the maintenance of anxiety. Creating a step by step plan to face your fears is a good way to reduce anxiety. This involves breaking down a challenge or goal into small, manageable steps that feel achievable, and then trying out the steps.
To start this, make a plan to slowly and gradually do the things you would normally avoid. For example, a common fear is having to talk in public. This could be broken down by practising alone, then in front of a mirror, then practising in front of family members, then practising in front of friends or a teacher before giving the talk.
When you feel anxious, having coping statements on hand can help you challenge your thoughts. For example, ?If I get anxious, I will try some calm breathing?, ?I just need to do my best?, ?I can do it?, ?I am not weak for having anxiety, everyone experiences anxiety?, ?I?m strong for challenging myself to face the things that scare me?.
Increasing enjoyable activities
Try reducing your stress by introducing daily enjoyable activities, small things such as watching a good TV programme, going for a bike ride, playing a computer or board game with others.
Increasing problem solving skills
When problems arise break the solution down into steps, think about different options, and never be afraid to ask for help if you need it.
Talking to others
Talking about anxiety can be really hard for some people. However, it?s really helpful to talk about your feelings and challenges with someone you can trust. We?re here if you need us and there?s lots of support available in your area.�
Some children and young people feel that their anxiety is their fault. They blame themselves for being anxious. Some might not even know what they?re experiencing is anxiety. This can make it really hard for them to talk to other people about how they feel and to ask for help. When they do manage to talk about how they feel, they often feel much better, and experience a sense of relief.
If you?ve tried to support the child or young person by using the techniques on the ?managing anxiety? page and they?re still having difficulties, there?s lots of support available in your area. You can find information about this in the Local Offer.
If the symptoms of anxiety are interfering significantly with their day to day life and/or you are concerned that they may be at risk of harm, for example by not eating or by harming themselves, talk to your GP, another health professional about what other support is available.
If you need urgent help, call 0300 365 1234.
You can find help at:
- Anxiety UK- provides information on anxiety and treatments
- Young Minds�- support for those worried about a young person?s behaviour or mental health. You can also call their free helpline on 0808 802 5544 Mon-Fri 9.30am-4pm
- Young Minds also have a parents helpline for advice to parents and carers worried about a child or young person under 25
- AnDY�- offer assessments, treatment and research to children and young people suffering from anxiety or depression
- Youthline�- a free, confidential counselling service for�young people attending secondary school and adults who care for and support young people.
- On my mind -�information that has been coproduced with young people. It contains information, advice and resources to help young people support their own mental health, including signposting to sources of support in times of crisis and tools to help young people manage their own wellbeing.�The free digital resources are designed for use by children and young people between the ages of 10 ? 25.
Understanding anxiety, depression and CBT course
Anxiety and depression are terms discussed widely, in different media and amongst family and friends. But what do those labels actually mean?�Local colleagues from the University of Reading are running a 5 week online course which is open to anyone who wants to understand more. You'll explore what it means to have anxiety or depression and how they are identified. The course will also demonstrate the leading evidence-based treatment?Cognitive Behaviour Therapy.
This course is not intended to be a self-help treatment for anyone experiencing anxiety or depression, nor can it be used to formally diagnose yourself or anyone else but it will help you to understand more about these conditions and how they might be experienced by family, friends etc.
Creswell, C. & Willetts, L. (2007). Overcoming Your Child?s Fears and Worries: A self-help guide using cognitive behavioural techniques. London: Constable & Robinson.
�Willetts, L. & Creswell, C. (2007). Overcoming Your Child?s Shyness & Social Anxiety: A self-help guide using cognitive behavioral techniques. London: Constable & Robinson.
�Michael, Tompkins & Martinez (2009) My anxious Mind: A Teen?s Guide to Managing Anxiety and Panic.�