How to spot anxiety in your child – and how to help them
Around one in six children and young people have a probable mental health condition, while many struggle with challenges from bullying to bereavement. With today being World Mental Health Day, it's important to remember that 50% of mental health problems are established by age 14 and 75% by age 24, according to a leading UK charity.
And anxiety disorders especially are something we're seeing more and more young people experience, affecting 5-19% of all children and adolescents, and about 2-5% of children younger than 12 across the country.
So, with early detection and intervention key, Dr Melanie Smart of Chichester Child Psychology shares the different ways anxiety in children can manifest (it's not always as easy as you might think to spot) – and what parents can do to help.
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Children can be anxious about lots of things from school to relationships, but generalised anxiety 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.
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Fears and phobias
Fears and phobias can often develop because something HAS happened such as an illness or death. And they are – unsurprisingly – on the rise since the pandemic started. I’m seeing children who are more fearful of germs or illness due to Covid and some are more agoraphobic, frightened of going outside or mixing with crowds of people.
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 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.
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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.
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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 on for free on 0808 802 5544 from 9:30am - 4pm, Monday - Friday.
Watch: Tackling children's anxiety by making worries come to life