Worries and anxieties: information for young people

We all get frightened or worried from time to time. Usually fear is a good thing as it keeps us from getting too close to danger. Sometimes though, we can feel frightened or worry about things 'too much' and this can get in the way of enjoying life. This sort of fear or worry is called anxiety.

How common is it?

Anxiety is one of the common mental health problems. Nearly 300 thousand young people in Britain have an anxiety disorder. So you are not alone. Lots of people however, suffer in silence. It is important to recognise your problems and seek help especially when it starts affecting your everyday life.

When we feel we are in danger, our brains tell our bodies to get ready to run away quickly. This means that if you have anxiety you may feel this in your mind, as well physically in your body.

The symptoms of anxiety include:

In your body or physically you may feel:

• sick
• shaky/dizzy
• heart racing
• short of breath
• ‘butterflies’ in the stomach.

In your mind you may:

• feel upset
• feel worried
• irritable
• unable to relax
• have difficulty in concentrating.

Anxieties are grouped based on what the fear or worry is about. The groups are also helpful in understanding your difficulties and treating them.

Fears and phobias

You might remember being scared of the dark or insects when you were little. This is normal and as we get older, we usually grow out of these fears or are able to manage it without worrying too much about it. Sometimes fears about particular things (e.g. needles, animals) or places (e.g. darkness, heights) can be really strong and don’t go away. They stop you from doing normal things and interfere or take over your life. These fears are called phobias. We may need extra help to cope with a phobia.

General anxiety

Some people feel anxious most of the time for no obvious reason. When it is really bad, it can stop you concentrating at school or having fun with friends and family. Sometimes feeling anxious and sad can go together. You may need help to be able to feel and cope better.

Separation anxiety

Separation anxiety is feeling worried or anxious when you are away from your parents/family/guardians. It is normal for very young children to feel scared and worried when they are not with the people who normally look after them. If it is still a problem when you are older or a teenager, this can make it difficult to go to school or go out with friends. If this happens it is best to get help.

Social anxiety

In simple terms this is really bad shyness. You may be comfortable with people you know well, but find it very worrying to be with new people, places or social occasions like parties. Standing up in class or assembly can be extremely difficult for you, as you are worried about making mistakes or what others think of you. This means you may tend to avoid situations which involve other people. When this happens, it is important to seek help.

Panic disorder

A panic attack is an extreme episode of anxiety that seems to occur for no reason. It may feel as if your mind has gone totally out of control. Panic attacks have a start and a finish; they are not continuous, although you might worry about when the next one will happen.

During an attack, you can have physical feelings of anxiety (see above) along with frightening thoughts, like thinking you are going to die, or “go mad”. It is rare for younger children to have panic attacks on their own, without another form of anxiety like those mentioned above. In teenagers this becomes more common. When the fear of having one or frequent attacks stop you from doing your daily routine or enjoying life, this is called panic disorder.

Some children and young people may have other types of anxiety, such as post-traumatic stress disorder or obsessive compulsive disorder.

We do not really know what causes this illness. However, sometimes you may find the problems started after upsetting or frightening experiences in your life (like being bullied at school, having an illness, loss of a loved one or parents separating).

You may be able to manage one thing, but when lots of things happen at once, like parents separating, moving house and changing school, it can become much more difficult.

Anxiety tends to run in families, so if someone in your family is known to worry a lot, you may be more likely to worry as well. Some of this will be passed on in the genes, but you may also ‘learn’ anxious behaviour from being around anxious people. If your family or friends are anxious or harsh, it can make your anxiety worse. In this case it may help to talk to them about it.

Some people may grow out of anxiety, but a few may still experience anxiety when they grow up. The good news is that it is treatable - this means that there are things that can be done to reduce feelings of anxiety.

There is a lot you can do with the help of family and good friends to make you feel better.

• Try to give yourself more time to get used to any changes that happen, like at home or at school, as change can be more difficult when you worry a lot.
• Check out whether you are picking up on someone else’s worry, rather than it being just yours.
• Get support from good friends and family; you might also want to talk to someone outside the family like a teacher or mentor.

The type of specialist help offered here will depend on what is causing the anxiety. Usually it will be a form of talking therapy, like Cognitive Behavioural Therapy (CBT). CBT can help you understand and deal with the causes of your anxiety and to find strategies for coping. You may be seen on your own or with your family. 

Occasionally, once you’ve tried a talking therapy, you might also be given a medicine to help if your anxiety problem has not got much better. A type of antidepressant, called an SSRI, is usually used.

Living with anxiety problems is difficult, but it is treatable and doesn’t have to keep making you feel unhappy.

One of the worst things about my phobia was that I had to keep it secret. When my friends invited me to their birthdays, I had to say I was busy, because I couldn’t go anywhere near balloons.

I’ve always disliked balloons. But last year I decided that my fear was out of control, and I had to do something about it. I went with my mum to see our GP, who sent me to a specialist. A couple of months later, we had the first of a course of eight ‘Cognitive Behavioural Therapy’ sessions.

The therapist began by telling me that plenty of people have phobias and that balloon phobia even had a name (‘globophobia’). It really helped to know that other people had the same problem.

She asked me about my early life and tried to work out how my phobia had started. We talked about how I react to different stressful situations, marking how bad I’d feel on a scale of 1 to 10. She explained that my fast pulse rate, and my feeling hot and tense, and needing to escape were a normal response to stress. She taught me how to control my breathing, relax and talk to myself positively to control my anxiety.

Gradually, each week, I had harder things to do – at first just touching balloons, but by the end of the course - bursting them. On the way to the sessions I often got quite upset, because I knew I was going to have to face my greatest fear. It was hard work, and I nearly gave up.

I still don’t like balloons, and would rather not have them near me. But thanks to the therapy, I can now accept invitations knowing that I can deal with my fears.

I don’t know about you, but I have always been a worrier, like my grandmother. Every year, we would plan our family trip to India and it would start … worrying about the plane journey … worrying about falling ill, … and just before take-off I would get those horrible “butterflies”, sweaty hands and the feeling that I couldn’t breathe. Sometimes I would feel my heart beating and I thought I was dying or going “crazy”.

Last year, before my exams, my worrying got really bad. The pressure in secondary school has been high and everyone in my family has always done well and gone on to University, so I knew I had to study extra hard. It got so bad that I couldn’t concentrate. I felt shaky and nervous at school and even started to cry most days. I wasn’t sleeping well because I was so nervous and was too embarrassed to tell mum and dad.

I ended up pouring my heart out to the school nurse which was the best thing I ever did. She got in touch with my mum, and after seeing the GP, I went to see a team of specialists at the hospital.

Don’t worry… I didn’t want to be the “girl who sees the shrink” either but it’s not like that. The team can have all sorts of people like doctors, nurses, psychologists and social workers. They reassured me and helped me and my family to see that my symptoms were real (just like when you have asthma). I went on to have a talking therapy called CBT. This involves a number of weekly sessions with the therapist. I didn’t even need to take medication. Although, I will always be a worrier I feel so much better, and I’m even looking forward to this year's India trip."

Anxiety UK - A charity providing information and support for people suffering with anxiety problems.

Epic friends - Mental health problems are common. This website is all about helping you to help your friends who might be struggling emotionally.

YouthNet UK - Online charity which guides and supports young people, enabling them to make informed choices, participate in society and achieve their ambitions.

Useful CD: Rays of Calm, Christiane Kerr, Audio CD/Audiobook: CD from the "Calm for Kids" range created for teenagers. It talks through various relaxation techniques and visualisations designed to promote a sense of calm and wellbeing and to help teenagers deal with stress.

Ipser JC et al., (2010): Pharmacotherapy for anxiety disorders in children and adolescents, Cochrane Depression, Anxiety and Neurosis Group. Intervention review.

O'Kearney RT, Anstey KJ, von Sanden C. Behavioural and cognitive behavioural therapy for obsessive compulsive disorder in children and adolescents. Cochrane Database of Systematic Reviews 2006, Issue 4.

Evidence-based guidelines for the pharmacological treatment of anxiety disorders, (2005): British Association for Psychopharmacology.

Green, H., McGinnity, A., Meltzer, H., et al. (2005). Mental health of children and young people in Great Britain 2004.

National Institute for Health and Clinical Excellence: Guide to self help resources for generalised anxiety disorder (2011).

Revised by the Royal College of Psychiatrists’ Child and Family Public Education Editorial Board. 

Series Editor: Dr Vasu Balaguru

With grateful thanks to Dr Kashmeera Naidoo

This leaflet reflects the best possible evidence at the time of writing.

© March 2012. Due for review March 2014.