Anxiety

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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.

Common types of anxiety

The most common types of anxiety are:

Social anxiety�

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�

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

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

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

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.

What you might see

Anxiety disorders can have physical, psychological and behavioural symptoms that can vary between each individual.

The most common symptoms are:

Physical symptoms

Increased heart rate, headaches, nausea, vomiting, sweating, restlessness, dizziness, muscle tension, shaking, tingling and difficulty breathing.

Psychological symptoms

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.

Behavioural 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

How you can help

Breathing techniques

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.

Grouping techniques

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:

  1. Start by slowly breathing in and out
  2. SEE:look around for5things you canseeand say them out aloud. For example, you could say, I see the television, I see the mug or I see the yellow car outside
  3. TOUCH:think of4things you canfeeland 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
  4. SOUNDS:listen for3sounds that you canhearand say them aloud. This could be the sound of the birds tweeting outside, the music on the radio or the cars driving past
  5. SMELL:think of2things you cansmell. 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
  6. TASTE:think of1thing you cantasteand say it out aloud. If you can?t taste anything, you can say some of your favourite tastes, such as chocolate or mints
  7. Finish by slowly breathing in and out
�Reducing avoidance

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.

Coping statements

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.�

When to ask for help

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.

You can also refer your child to our services

If you need urgent help, call 0300 365 1234.

Self-help and other support

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 foryoung 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.

Useful reading:

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.�

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