Anxiety

The feeling of anxiety is something we all experience and is necessary for survival. It results from the release of adrenalin into the bloodstream in response to things we find threatening, and makes us alert so that we can deal with day to day challenges.

People differ, not only in what they find threatening, but also in the degree of anxiety which is felt.  Some are ‘laid back’ for example, and not easily worried by difficulties.  Others may be more sensitive and are prone to being fearful about even minor things.  If this is the case, anxiety may then begin to affect the ability to function, and can become a long term problem with educational, health and happiness implications.

Children and anxiety

All children go through stages of anxiety when they are growing up.  For example babies and toddlers experience fear of strangers as part of normal development, pre-school children may show distress when going into nursery settings, while older children/teens may suffer performance anxiety when faced with school plays or exams.  Other triggers may include particular things such as the dark, spiders or clowns.

These responses, when they are short term, are not harmful and should disappear if the child is helped and supported.  Sometimes, however, children do not ‘outgrow’ their fears or they experience a traumatic event.  The fears become intense, and the child shows signs of excessive stress.  There is evidence that this type of health problem within our childhood population is becoming more common, and it is currently estimated that around 11% of 14 to 16 year olds suffer generalised anxiety disorder (anxiety all the time) in any given year.

Common causes of childhood anxiety

Although anxiety is part of normal development there are additional reasons why a child may become anxious.  These include the following:

• School problems – children who are bullied, lack friends or who find learning difficult will tend to worry a lot
• Health problems – children who need regular medical treatments or who have frequent stays in hospital will find life more stressful
• Developmental problems – children who have speech and language difficulties, Autistic Spectrum Disorder or ADHD are all likely to have high anxiety levels
• Family problems including domestic violence – children/teens feel insecure and unsafe when they hear arguments or witness fighting
• Divorce or separation – children find adult relationship breakdown emotionally painful and often confusing
• Different home settings – children are likely to be anxious if parents in different home settings do not work together and provide consistency
• Parenting styles – poor boundaries, authoritarian attitudes and over-protectiveness can leave children feeling unsupported and lacking in confidence
• Death or illness or parent or close relative – children, especially if very young, will feel threatened by loss. They may also feel insecure due to changes to normal daily life and routines
• Traumatic experiences – any major event such as a burglary or road traffic accident

How to spot if a child is anxious

There are four areas which can be affected if a child is suffering from unresolved anxiety.  These are physical, thoughts, emotions and behaviour.  Listed below are some of the signs a child may show.  These may be present all the time or come and go.

• Breathlessness, sweating, complaining of ‘butterflies’, chest/stomach pain, feeling sick
• Fearful or panicky
• Quiet/withdrawn, ‘acting out’, irritability, temper tantrums, tearful/emotional
• Negative thoughts/obsessions
• Poor concentration and restlessness
• Over dependency
• School refusal
• Sleep problems – difficulty in falling asleep, bad dreams, frequent waking

How to reduce the risk of anxiety problems developing

Anxiety cannot be avoided in life.  It is part of human experience and is a vital learning tool.  There are many things that parents can do to increase tolerance of anxiety and help children face fear positively.  Some suggestions are listed below:

• Child health – management of anxiety should be balanced with managing life in general. For this reason parents should consider promoting a healthy lifestyle for their children.   This includes giving a balanced diet, ensuring the child is rested and has the opportunity to exercise on a daily basis.  Exposure to electronics (TV, phones, consoles and computers) should be limited and replaced by creative/social activities
• Parental health – the challenge of raising children places many demands on caregivers. Children sense when adults are stressed and this in itself can be the cause of anxiety.  Parents are encouraged to take care of themselves and to seek support if needed
• Home health – children like to have a sense of control in their lives. They feel calmer when life is predictable (routines), and they understand the limits for behaviour which should be consistent, understood and universal.  Adults and mature siblings need to address any excessive stress and tension within the household and provide good role modelling
• Communication – set aside quality time every day to talk with your child about specific worries. Help them think problems through and reassure them so they feel supported
• Build self-esteem – reward positive behaviours, give praise and help them take (age appropriate) responsibility

What to do if your child is very anxious

If you notice that anxiety is beginning to have an impact on how your child is able to function or on the quality of family life, the first step is to seek help.  The paediatrician will give information about agencies who are experienced in the field of child mental health, including how to get referred if necessary.  Seeking professional help is important, but parents also play a key role in the management of anxiety and should consider the strategies listed below to support an anxious child:

• Find out more – learn to recognise anxiety and how it works
• Become an expert – find out about the techniques and tools which will help children manage and cope (including calm breathing and talk time)
• Give support – do not judge worried thoughts and anxious feelings, but reassure the child by showing empathy. Provide simple, accurate information about anxiety so they can understand (knowledge is power)
• Talking – spend nurture time with the child each day. Encourage them to ‘open up’ and to describe feelings using words or pictures.  Help them to develop problem solving skills and reward their success
• Build resilience – by teaching the child to face fears confidently and take reasonable risks in life

Further information

For more specific help and information, the resources listed below may be helpful:

National Autistic Society

www.autism.org.uk 

For parents/carers of children diagnosed with or suspected to have Autism

Young Minds

www.youngminds.org.uk

The voice for young people’s mental health and wellbeing

Parent Helpline: 0808802 5544

NHS Choices

www.nhs.uk

Information about NHS treatment and services, including specialities of children’s mental health

Anxiety BC

www.anxietybc.com

Evidence based information about anxiety (children/teens) together with self-help tools and resources

Anxiety UK

www.anxietyuk.org.uk

UK charity providing information and support for people and families affected by anxiety disorders

Helpline: 08444 775 774 (Monday to Friday, 9.30am to 5.30pm)

MindFull

www.mindful.org

An online service for 11 to 17 year olds giving mentor support, information and advice about mental health and emotional wellbeing

Childline

www.childline.org.uk

Free and confidential helpline for children to talk about worries they may have, big or small

Books for children

The interactive books listed below are aimed at 6 – 12 year olds.  Please research before considering any purchase to ensure suitability for your child.

What To Do When You Worry Too Much

A Kids Guide to Overcoming Anxiety
Dawn Huebner PhD
Magination Press

What To Do When You Grumble Too Much

A Kids Guide to Overcoming Negativity
Dawn Huebner PhD
Magination Press

What To Do When You Dread Your Bed

Overcoming Problems with Sleep
Dawn Huebner PhD
Magination Press

Books for parents/caregivers

Overcoming Your Child’s Fears and Worries: A Self-Help Guide to Using Cognitive Behavioural Techniques

Cathy Cresswell and Lucy Willets

For parents/caregivers who also suffer from anxiety

Mid Essex IAPT

Psychological therapies service designed to help people manage everyday problems.  Self-referral accepted from any adult registered with a Mid Essex GP.

Don’t Panic Self-Help

Easy to use app covering topics including stress and worry.

Anxiety UK

Details already listed.

Samaritans

www.samaritans.org

Confidential emotional support for anyone in distress or worried and upset.  You do not have to be suicidal to use this service.

Phone: 116 123