How to spot anxiety in your child and how to help them

Around 10% of children and young people (five-16 years) have a clinically diagnosable mental health problem, ranging from depression to anxiety to eating disorders.

But 70% of children and adolescents who experience mental health problems have not had appropriate interventions early enough.

This Children's Mental Health Week and any week, it's important to remember that half of mental health problems are established by just 14 (and 75% by 24), according to a leading charity, meaning spotting the signs and getting them help promptly is key.

With anxiety one of the most common mental health difficulties among children, here Dr Melanie Smart of Chichester Child Psychology explains first hand the different ways it can manifest (it's not always as easy to recognise as you might think) – and what parents can do to help.

Generalised anxiety

Children can be anxious about lots of things from school to relationships, but generalised anxiety, or generalised anxiety disorder (GAD), means they worry about most things in a non-specific way. Generalised anxiety tends to be about abstract things that have happened in the past or future – terrorism, COVID-19, war, even things they hear on the news about politicians. The child might hear it then worry about whether they are safe or someone is going to hurt them.

PARENT TIP: What often happens with generalised anxiety is that it sucks the family into doing the very thing that anxiety thrives on – reassurance. By reassuring a child that something won’t happen, the message you’re sending is that it might happen.

Instead, help them find out for themselves and reassure themselves. This might mean checking the locks on the doors before they go to bed if they’re afraid of someone breaking in or researching something on the internet to find out what the chances are of something happening. Then ask them to reassure themselves and feel more confident.

Fears and phobias

Fears and phobias can often develop because something HAS happened such as an illness or death. I've seen children who are more fearful of germs or illness due to COVID-19 and some are more agoraphobic; frightened of going outside or mixing with crowds of people [while this may be improving now, it will be replaced with new fears of the time].

PARENT TIP: Don’t avoid doing the things that children are frightened of as a gentle exposure approach is best. If they’re fearful of going outside, encourage them to venture into the garden, perhaps with a friend.

Activities like baking or gardening expose children to mess and help with fears around germs and illness. If they feel the need to keep washing their hands, ask them to wait for a minute before they clean up. Also use ‘modelling’ – that’s showing how comfortable you are with flour or dirt on your hands.

Separation anxiety

Separation anxiety about going TO somewhere is a fear of the unknown while anxiety about leaving somewhere or someone is a fear that something will happen while they’re away. You might notice that your child stalls for time when they are getting ready or indeed might refuse to get ready at all.

They might complain of tummy or headaches before they go somewhere or may be openly distressed about going and argue with you. They may seek reassurance and ask you to go with them and stay with them.

PARENT TIP: When the anxiety is about going TO somewhere, give the child as much information as possible about the place beforehand. If it’s a new school, ask if you can visit it beforehand, look it up online or ask to go into school with a friend. If the anxiety is more about leaving someone or somewhere, reassure them that you will be fine and that nothing is going to happen.

Perhaps give the child an item from you – a hair clip or keyring – so they have some kind of connection to you. Or draw a heart or smiley hand on your hand and theirs so they can look at it and feel close to you while you’re separated.

Social phobia

More common in pre-teen to teenage children and in neurodiverse children, these are very specific anxieties about friendships, relationships or how others perceive you. The child might feel judged or ashamed and won’t feel safe in a relationship and is not able to trust people. They may struggle to understand relationship dynamics and so avoid them.

PARENT TIP: Lots of validation is required. Let them know that it’s perfectly normal to be worried about friendships and try to expose your child to different friendships, perhaps by finding a club for an activity they really love. It’s great for children to have friendships with older children so look out for schools with buddy systems, where older children buddy up with one of the younger kids.

Panic

Around 15% of the children I see with anxiety suffer from panic attacks and it tends to show up mostly in older children. The signs are breathlessness, hyperventilation and raised blood pressure and there tends to be a very specific trigger such as having to go to a certain place or be with a certain person.

But many of the children I speak to don’t know why they are being triggered and interestingly, I’ve noticed that children who have had COVID-19 who suffered from palpitations or breathlessness, have gone on to have panic attacks in a kind of biological feedback phenomenon.

PARENT TIP: It’s important to manage the physiological symptoms – slowing the breathing, opening up the posture and relaxing the muscles. Then it might be worth trying to identify what might have triggered the attack so you can prepare next time. Panic attacks are never pleasant, but most people get over them fairly quickly.

With any anxiety issue, it is important to normalise and encourage exposure and confidence. It’s only when people are suffering to a debilitating level that is affecting daily functioning that they should seek professional help. However, if you are concerned about a child or someone you know, it is never too early to ask for support.

Speak to a doctor, visit the NHS website for information Children and young people's mental health services (CYPMHS), or call Young Minds' parents helpline for free on 0808 802 5544 from 9.30am - 4pm, Monday - Friday.

• Read more: Signs your child is struggling with their mental health (Yahoo Life UK, 7-min read)

• Read more: Mental health dangers of screen addiction and how to have a digital detox (Yahoo Life UK, 7-min read)

• Read more: Eating disorder manifesto and toolkit for schools launched to tackle surge in cases (Yahoo Life UK, 4-min read)

Watch: Tackling children's anxiety by making worries come to life