Mental Health and Growing
Up Factsheet
Worries and anxieties - helping children to cope:
information for parents, carers and anyone who works with young
people
About this leaflet
This is one in a series of leaflets for
parents, teachers and young people entitled Mental Health and
Growing Up. These leaflets aim to provide practical,
up-to-date information about mental health problems (emotional,
behavioural and psychiatric disorders) which can affect children
and young people. This leaflet describes the different types of
anxieties that children might feel and some of the reasons behind
these. It also offers practical advice on how to deal with these
worries and anxieties.
Introduction
Children, like adults, have all sorts of
strong feelings about what is happening to them. It's natural for
them to feel fearful or worried from time to time. However, a small
group of children and young people have severe anxiety which causes
a lot of distress, and can seriously affect the way their everyday
lives.
How common is it?
Anxiety is one of the common mental health
problems. Nearly 300 thousand young people in Britain have an
anxiety disorder. Lots of people, however, suffer in silence. It is
important to recognise their problems and seek help especially when
it starts affecting their everyday life.
Growing up: different types of anxiety
Anxieties are grouped on what the fear or the
worry is about. These groups are helpful in understanding what the
difficulties are and how to treat them.
Fears and phobias
Young children often develop fears, for
example of animals or of the dark. A phobia is an extreme fear
which causes a lot of distress and affects the child's life
significantly. For example, a fear of dogs would be called a phobia
if it means that a child refuses ever to go to the park to
play.
Most children either grow out of their fears
or learn to manage them with support and encouragement, but it is
much more difficult to cope with a phobia without some extra
help.
General anxiety
Some youngsters feel anxious most of the time
for no apparent reason. It may be part of their temperament, or it
may be part of a pattern of behaviour that is shared with other
members of the family. If the anxiety becomes very severe, it can
mean that the child will not want to go to school, cannot
concentrate or learn, and is not confident with other people.
Separation anxiety
Worry about not being with a child's regular
care-giver is a common experience for most children. It normally
develops at 6 months, and can go on in some form during the
pre-school years.
It can make going to sleep, parents leaving
for work, or settling at nursery or school very difficult at times.
If it is extreme and affects the child's development, education and
family life, it may be useful to get some additional help.
Social anxiety
It may be helpful to think of this as an
extreme, sometimes disabling, type of shyness. It means that
although children and young people are not affected in the company
of people they know and family, they find it very worrying to be in
other social situations. This means that they will usually avoid
them. This causes problems for the child in making new friends or
dealing with situations at school. Older children describe it as a
fear of humiliation or embarrassment which leads them to avoiding
social situations.
A small minority of children and young people
may develop other specific types of anxiety, such as post traumatic
stress disorder or obsessive compulsive disorder. Unlike young
people and adults, it is extremely rare for children to suffer
panic attacks.
What are the signs of anxiety?
Anxiety can cause both physical and emotional
symptoms. This means it can affect how a person feels in their body
and also health. Some of the symptoms are:
- feeling fearful or
panicky
- feeling breathless, sweaty,
or complaining of ‘butterflies’ or pains in the chest or
stomach
- feeling tense, fidgety,
using the toilet often.
These symptoms may come and go. Young children
can't tell you that they are anxious. They become irritable,
tearful and clingy, have difficulty sleeping, and can wake in the
night or have bad dreams. Anxiety can even cause a child to develop
a headache, a stomach-ache or to feel sick.
What causes these worries and anxieties?
We do not really know what causes this
illness. However several things can contribute to their anxiety
like genes, where they live, having upsetting or traumatic
experiences.
Anxiety tends to run in families, so if
someone in your family is known to worry a lot, they may be more
likely to worry as well. Some of this will be passed on in the
genes, but they may also ‘learn’ anxious behaviour from being
around anxious people.
Children who are bullied, lack friends or have
trouble with their school work often worry a lot .
Child who have experienced a household fire or
a burglary, a car accident or some other frightening or traumatic
event, might suffer from anxiety afterwards. They might also
develop post-traumatic stress disorder.
Children who have to cope with stressful
situations like bereavement, parental illness or divorce often
become anxious and insecure. They may be able to manage one event,
but may struggle to cope if several difficult things happen
together, such as parents divorcing, moving home and changing
school.
Children need parents or caregivers to sooth
them effectively. Young children can feel worried and anxious if
they hear or see their parents arguing or fighting (see our
factsheet on good parenting). If children feel their family or
friends are anxious or harsh, it can make them feel more anxious.
This leaves children feeling unsupported, insecure and lacking in
confidence and can also be linked with separation anxiety in
children.
Do children grow out of it?
Most children grow out of it, but a few
continue being anxious, and can sometimes become depressed as
adults.
Even if they do not become anxious adults,
anxiety can limit a young person's activities which can affect
their development in the long-term. Not going to school, for
example, means missing out on education and making friends.
Loneliness and lack of confidence can be long-term problems. The
emotional effects of traumatic experience can also be
long-lasting.
What can I do to help?
A lot can be done to stop children being
anxious. Parents and teachers can help by remembering that
children, like adults, may get anxious about sudden change.
- It helps if you can prepare them in
advance and explain what is going to happen and why.
- Regular routines around bedtime and getting
ready for school can help very young children with separation
anxiety.
- There may be books or games that can help
children to understand upsetting things, such as serious illness,
separation or bereavement.
- Children over the age of five often find it
helpful to talk about their worries to an understanding adult,
which could be someone outside the immediate family.
- They may need comfort, reassurance and
practical help with how to cope.
If your child is showing signs of anxiety, it
is important that you can show them that you care and want to
understand the reason why:
- Think about whether there is
something going on in the family that could be causing worry.
- Are they picking up on your
own worry?
- Is something happening at
school or with friends?
All families have times when they have to deal
with a lot of stress and worry. At times like these, you or your
child might need extra help and support from friends, family
members or others.
Where can I get help?
If your child is so anxious that they can't
cope with ordinary day-to-day life, more specialist help is needed.
Your GP will be able to advise you, and may suggest referral to the
local child and adolescent mental health service (CAMHS) (see our
factsheet on Who’s Who in CAMHS). The type of specialist help
offered here will depend on what is causing the anxiety.
Basically, it will involve finding ways of
overcoming the worries and building confidence step by step.
How is it treated?
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 them understand what causes their
anxiety and find strategies for coping. Parents are encouraged to
be actively involved in helping their children manage their anxiety
and are advised how to do this effectively.
Occasionally, they might also be given a
medicine to help if their anxiety problem has not got much better.
A type of antidepressant, called an SSRI, is usually used.
Anxiety problems can be really difficult to
live with for both the young person and family, but it is
treatable.
Further information
Anxiety UK
A charity providing information and support for people suffering
with anxiety problems.
TheSite.org
Website by YouthNet UK, a charity provides
factsheets and articles on all the key issues facing young
people.
The Child Anxiety
Network
Provides thorough, user-friendly information
about child anxiety.
Website on Social anxiety
disorder
Young Minds Parents
Helpline
For any adult concerned about the emotions and
behaviour of a child or young person. Parents' helpline
0808 802 5544
Youth Access
Offers information, advice and counselling in
the UK.
Further Reading
National Institute for Health and Clinical
Excellence: Guide to self help resources for
generalised anxiety disorder (2011).
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.
References
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.
- 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. Royal College of
Psychiatrists. This leaflet may be downloaded, printed out,
photocopied and distributed free of charge as long as the Royal
College of Psychiatrists is properly credited and no profit is
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