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Anxiety

September 05, 2021

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Team Mindsum

About the author: This article is written by our team of researchers and writers. Our content is published after careful review and approval by the editorial board.

What is Anxiety?
Types of Anxiety Disorders.
Symptoms of Anxiety in young children
Symptoms of Anxiety in young adults
Causes of Anxiety in children and young adults?
How does Anxiety affect a child or a young adult?
Treatment options
What types of professionals are involved?
The recovery journey
How to support someone with Anxiety
How can parents support their child with Anxiety?
Useful resources

What is Anxiety?

Children and young people feel worried and fearful about different things sometimes, which is a normal part of growing up. This is often the case when they are faced with challenging tasks, unfamiliar people and unfamiliar situations. Anxiety can be a natural stress response, however, constant feelings of unease, worry or fear, particularly about things that are about to happen or things that we think could happen can become a problem.

Anxiety can therefore be a problem when these worries and fears are so severe and persistent that they start to interfere with normal activities in the child’s everyday life.

For example, on the first day at a new school, all children feel nervous. But some may feel so nervous that they fail to turn up.

Anxiety is one of the most common mental health problems experienced by young people. But lots of people still suffer in silence. It is important to recognise anxiety and find the right support so that more serious mental health problems can be prevented. It is important to recognise anxiety and find the right support.

Types of Anxiety Disorders

Generalised Anxiety Disorder (GAD) is the persistent worry about situations. Symptoms can include:

Spending most of the days worrying
Difficulty stopping the worry
Constantly needing reassurance
High irritability
Muscle tension
Overworking to perfection
Avoiding tasks due to having a fear of not performing well.

Specific Phobia is an excessive fear directed towards a specific object or situation. This can be for example to dogs, needles or darkness. Symptoms include:

Extreme fear about a specific thing
Crying, freezing, clinging or throwing tantrums when the individual is close to the feared object or situation.
Avoidance of the feared object or situation.
Extreme distress if avoidance is not possible.
The avoidance of the object or situation interrupts or interferes with everyday activities.

Social Anxiety Disorder is the intense fear of being in social situations. Symptoms can include:

Fears being around and talking to people
Avoidance of social situations
Feelings of intense stress during social situations
Constant worries about being embarrassed, rejected or laughed at by others
Replaying scenarios or conversations and over-analysing them
Hiding, crying or freezing when faced with social situations

Other types of anxiety disorders in young people include panic disorder, obsessive-compulsive disorder and post-traumatic stress disorder.

Panic Disorder is where an individual has frequent and regular panic attacks with no apparent trigger. For more information about panic attacks see our page.

“Jess just moved to a new school recently. Even though the other girls have been very welcoming to her, Jess is afraid that she might come across as a loser to them. During break time, she feels worried and starts to sweat uncontrollably. She is terrified of saying the wrong thing and making herself look foolish. At home, Jess can’t help it but to replay events that happened at school to try and guess what others think of her. This got so bad that Jess thinks that it might be better for her to avoid going to break time altogether. Her parents are becoming concerned because they notice that Jess is just not herself when they pick her up from school. They believe that it might be helpful to speak to a mental health expert.”

Symptoms in young children

A normal experience for infants up to the age of 3 years. It can become a worry when the child does not grow out of it and has symptoms such as:

Being overly clingy
Intense worry for the safety of parents
Refusal to be alone without parents
Intense distress or panic at times of separation from parents
Persistent worry about sudden separation from parents
Refusal to sleep alone without parents
Concentration problems
Not sleeping properly and having bad dreams
Random outbursts of intense emotion
Constantly worrying
Clinginess
Being fidgety

Symptoms in young adults

Anxiety symptoms can manifest in emotional and physical symptoms. This is because when a person is having anxiety, their brain is signalling to them that they should run away. After all, there is a danger.

Anxiety in the mind may cause a person to feel:

Constant worry
Stress
High irritability
Unable to concentrate
Overwhelmed
Low mood and depression.
Depersonalisation

Anxiety in the body may cause a person to feel:

Nausea
Shaky
Sweaty
Dizziness
Racing heart
Shortness of breath
Headaches or other aches and pains.

Causes of Anxiety in children and young adults

‍‍The cause of anxiety in children and young people is likely due to a combination of different factors. Here are some factors to consider:

History of anxiety in the family
Being around anxious people
Having a stressful experience around a particular situation or object (e.g. social situation, animal, heights, planes)
Trauma (e.g. neglect, sexual abuse, accidents, deaths)
Big life changes (e.g. moving to a new house, death of loved one, starting a new school)
Situations at home or school (e.g. parents fighting, abuse, bullying, exams)

It is very common for children and young people with attention deficit hyperactivity disorder or autism spectrum disorder to suffer from anxiety.

How does Anxiety affect a child or a young adult?

Anxiety can affect a child’s life negatively as soon it begins to interfere with their everyday life activities. One way this can happen is that the physical symptoms can eventually take a toll on their body and health.

Anxiety can also impact their well-being as it can cause an increase in stress and result in children withdrawing socially decreasing their quality of life and having good relationships.

Anxiety also stops individuals from trying new things which can cause feelings of sadness as the individual will be unable to experience new things without feeling extreme fear.

Treatment

Medications

Medication for anxiety can be prescribed by a doctor or psychiatrist. It is usually given if the anxiety is severe and other methods such as therapy and self-help have not worked. Many people benefit from having both medication and therapy together when dealing with anxiety. But it is a good idea to try self-help methods and therapy first.

Self-Help Methods

Talking with loved ones about the anxiety
Engaging with self-help books available online
Doing breathing exercises when anxious
Maintaining a healthy lifestyle with exercise, healthy food and a good bedtime routine
Having therapy along with these steps

Psychological Therapies

Psychological therapies are important when treating anxiety disorders. It gives a child or young person the chance to tackle the root of the disorder. Two therapies are involved: Cognitive behavioural therapy and exposure therapy. These two therapies are usually referred to under the same umbrella of cognitive behavioural therapy.

Cognitive Behavioural Therapy (CBT) is a type of talk therapy that focuses on how we think and act and how this affects how we feel. Research has shown that CBT is highly effective in treating different types of anxiety disorders in children and young people. CBT can take anywhere between 6-20 sessions, depending on the severity of the anxiety and the child or young person’s age. CBT for anxiety is a short-term treatment.

The idea behind CBT with children and young people is that they get to talk about their anxiety and learn new skills, which they can use to fight off the anxiety. This all takes place in an environment of safety that the therapist can create for the child or young person. Depending on the child or young person’s age, the therapist will come up with a good way to help them overcome their anxiety using CBT.

With a young child, the therapist might focus more on changing the behaviours of the child. This is because young children may not be able to say how they feel and tend to show more behavioural signs of anxiety. With teenagers, the therapist may be able to use similar techniques that are used with adults, focusing on feelings, thoughts and behaviours.

The therapist always finds it useful to involve other family members in the process of treatment. This is because family members also play a part in influencing the child or young person on a day-to-day basis. So, if the therapist can get the family on board, there are greater chances of success.

Exposure Therapy is a type of behavioural therapy that focuses on helping the child to be exposed to their anxiety until it naturally fades away and can alleviate symptoms associated with anxiety disorders. Exposure therapy is commonly used as part of CBT. So, it is also a short-term treatment.

The idea behind exposure therapy is that if the child or young person can tolerate the anxious feelings for long enough, they will notice that the anxiety will eventually pass and nothing bad will happen.

The therapist will expose the child or young person gradually to situations from the least to the most anxiety-provoking. For example, to help a child with their intense fear of balloons, the therapist might first expose them to pictures and videos of balloons, before they face the real thing. The child or young person will eventually master each stage and will be able to stop the anxiety from taking over again.

What types of professionals are involved?

‍Different professionals may or may not be involved throughout the treatment process of anxiety for children and young people. These might include counsellors, psychotherapists and doctors/psychiatrists. These terms might be confusing, but the main difference is in the training that each of these professionals has received.

In the UK, there is not much of a distinction made between counsellor and psychotherapist. Both of these professionals provide therapy. However, there are some slight differences between these two professional terms. These are outlined below.

Counsellors

They are focused on helping people with what they need right now. Compared to psychotherapists, counsellors tend to have shorter training, and they help people deal with their issues on a more short-term basis. There may be school-based counsellors available that children and young people can approach at their school if they feel they need support with their anxiety. Here at Mindsum, many counsellors are available to provide support.

Psychotherapists

Psychotherapy training tends to be longer. Psychotherapists can also give counselling, but their approach to talk therapy is more in-depth, exploring the history and causes of certain behaviours and emotional issues. The psychotherapist will then treat the anxiety in this specialised way. Here at Mindsum, some psychotherapists are available to provide support.

It doesn’t mean that one professional is better than the other. All professionals in this field go through intensive training before they begin to practice. Also, many counsellors seek additional training throughout their careers.

Some doctors and psychiatrists can be involved in the treatment of anxiety for children and young people. There are more obvious differences between these two professional terms.

Cognitive behavioural therapists

This is the therapist the child/young person is most likely to be treated by for anxiety. These are therapists who have been trained in Cognitive Behavioural Therapy using this model to form an idea of a patient’s mental health difficulties and to treat them. The cognitive behavioural therapist will support the child in managing their worry, changing avoidance behaviours and other symptoms throughout sessions.

‍Doctors

These are professionals who are trained in medicine. This will likely be the family GP, who might find it necessary to prescribe certain medications that might help the anxiety, especially if the anxiety is quite severe.

Psychiatrists

These are professionals who are also trained in medicine. However, they also specialised in the field of psychiatry. So they can provide consultation and medication for a wide range of mental disorders such as anxiety, depression, schizophrenia, psychosis, bipolar affective disorder and so on.

The Recovery Journey

‍The journey of recovery from anxiety can look different for each child or young person, depending on the approach that the counsellor or psychotherapist uses. But some things are expected when going through therapy for anxiety.

Assessment

This is an important phase, where the therapist will take the opportunity to get a feel of what is going on with the child or young person. The professional might try to identify the type of anxiety that the child or young person is dealing with, along with other important background information. The child, young person and/or their parent will be asked important questions that will allow the professional to create a full picture of what is going on.

Therapy sessions

These sessions will take place at a time and regularity that suits the child or young person and their parents. An important aspect of the therapy session is the relationship the therapist will build with the child or young person. This will create a safe space that will encourage them to talk about their fears and anxieties. The child will learn skills that they can use against anxiety when it comes. Lots of work will be done in the therapy room that will help the child to be more confident to face their anxiety.

Homework

This can be an important part of treatment for anxiety, especially when having CBT. This is because anxiety is usually experienced in everyday situations in the child or young person’s life. So, homework tasks will help the child or young person master their anxiety outside of the therapy room. Parents involved in the treatment process might also be asked to help with the homework. Homework success is then discussed in upcoming therapy sessions.

Progress and setbacks

When having treatment for anxiety, there will be progress and there may also be setbacks. For example, the anxiety might become a bit worse at one point during the treatment. It is important not to feel discouraged if this happens. This can be very normal in the recovery process from anxiety. These situations provide opportunities to discover new ways to move forward together with the therapist.

Ending therapy

The therapist will eventually prepare the child, young person and parents for the end of therapy. This is a very important phase because the child or young person needs to become confident in coping with difficult feelings without relying too much on the professional. The end of therapy will take place once the child or young person has made a lot of progress or has completely recovered from anxiety. The child or young person will leave therapy with many skills that they can use without the help of the therapist.

Follow up

‍There might be an agreement with the counsellor or psychotherapist to have a follow-up meeting. This is to check how the child or young person is coping. If the child or young person is doing well, there will be no need for more support. But if they continue to have challenges with their anxiety or any other issues, this will be an opportunity to have extra support.

How to support someone with Anxiety

It is hard to know that your loved one is suffering from anxiety. Especially when the anxiety or panic attacks are so intense that they cause problems in their everyday life. Fortunately, there are some things that you can do to help. These are discussed below.

Understand Anxiety

‍It is a good idea to read as much information on anxiety and panic attacks as you can. Understanding anxiety and how it works will help you to recognise the signs that your loved one needs help.

Help them feel supported

‍It can be easy for someone to feel alone and isolated as they try to cope with anxiety. Your attitude towards their difficulties can make a difference.

Show acceptance

Often the anxiety might make them feel like they are somehow flawed. For this reason, it is important to let them know that they are not flawed and that they are loved with or without anxiety problems.

Give validation

The anxiety problem might be difficult for you to understand, but it is a real problem for them. Acknowledge the ways that anxiety is an issue for them with an attitude that is non-judgmental and non-critical.

Help them in a way they want to be helped

‍Instead of guessing, it is good to ask how they would like to be helped. They might already know what is helpful for their anxiety and what isn’t. Some people might want you to sit with them through a panic attack, whereas others might want you to give them some space to calm down. Other ways that your loved one might want help can include:

Doing a deep breathing exercise together

Exercising can help manage anxiety, so exercising with them can be a great way to support them

Remind them that the panic feelings will pass
Remind them that nothing bad will happen
Reassure them that you are there for them
Research their condition to understand it better
Help them to look up support groups, therapists or self-help resources

Know what NOT to do

‍When it comes to our loved ones, it makes sense to do whatever it takes to help them cope with an anxiety problem. This is not always a good thing. It is important to keep the following in mind:

Do not enable anxiety

You might think you are helping by enabling your loved one to avoid certain situations due to anxiety. For example, you might make sure that you are always present so that they can avoid taking elevators alone. This might seem helpful, but in the long run, your loved one won’t have any opportunities to face the feared situation. It is good to think about small ways that you could stop enabling the anxiety to continue.

Do not force a confrontation

At the same time, you must not force your loved one to face the feared situation. This might damage the trust between you and make the anxiety worse. If the anxiety is severe and any type of exposure is too much for your loved one, it is good to consider involving a professional.

Help them find the right support for them

‍If you find that anxiety is becoming a problem for your loved one you can encourage them to find support through a GP or therapist. If this involves your young child, you can contact these services. You might:

Help them to book an appointment with a GP or therapist.
Offer support when they attend appointments (e.g. waiting in the waiting room or attending some sessions if you need to)
Help them search for support groups or self-help resources (e.g. leaflets, mindfulness apps, relaxation sessions)
Encourage them to keep attending sessions and not give up
Give them small reminders to do their homework assigned by the therapist

Look after yourself too

‍You need to look after yourself. Whether you are a parent, family member or friend, you will be in a better position to give help, as long as you are taking care of your well-being.

To read more about looking after yourself, see our page on self-care when helping someone else.

How can I support my child?

When your child is anxious the best way to support them is to talk to them about their anxiety or worries to help them recognise signs of anxiety and encourage them to ask for help when they need it.

Some ways to support your child are:

Try and improve the family home environment as conflict and arguments

Encourage a healthy diet and exercise

Try not to be overprotective or anxious yourself
Provide distractions – go out with them for a walk or play games with them
Practice relaxation techniques with them e.g. yoga, meditation, breathing etc.

If after a while you see no improvement in your child's anxiety and it begins to have an effect on school, family and friendships it is best to seek professional help or visit the GP.