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. The
aims of these leaflets are 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 they lead their
lives.
Growing up: different types of
anxiety
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 meant that a
child refused 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 is around to varying degrees 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.
What are the signs of anxiety?
- 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?
Family history
Anxiety problems tend to run in families. If
parents or relatives are known to worry a lot, the children may be
more likely to do so. Some of this will be in the genes, but
children may also 'learn' anxious behaviour from watching their
anxious relatives. They may continue to be anxious if their parents
or caregivers do not have that the ability to sooth them
effectively.
Upsetting life events
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 parental divorce,
moving home and changing school.
Parenting that is harsh, inconsistent or over-protective
This leaves children feeling unsupported, insecure and lacking
in confidence and can be linked with separation anxiety in
children. Young children can also feel worried and anxious if
they hear or see their parents arguing or fighting (see our leaflet
on
good parenting).
School problems
Children who are bullied, lack friends or have trouble with their
school work often worry a lot (
see leaflet
18 on bullying).
Traumatic
experiences
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.
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.
Where can I get 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.
If your child is so anxious that they can't cope with ordinary
day-to-day life, more specialist help is needed. Your general
practitioner will be able to advise you, and may suggest referral
to the local child and adolescent mental health service. 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. Parents are encourage
to become actively involved in helping their children manage
anxiety and advised how to do this effectively.
References
- Carr, A. (ed.) (2000) 'What Works with Children and
Adolescents?' - A Critical Review of Psychological Interventions
with Children, Adolescents and their Families. London:
Brunner-Routledge.
- Goodman R. and Scott S. (2005) 'Child Psychiatry' (2nd
edition). London: Blackwell.
- Rutter, M. & Taylor, E. (eds) (2002) 'Child and
Adolescent Psychiatry' (4th edn). London: Blackwell.
- Scott, A., Shaw, M. & Joughin, C. (2001) 'Finding the
Evidence' - A Gateway to the Literature in Child and Adolescent
Mental Health (2nd edn). London: Gaskell.
Sources of further information
© [2008]
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 gained from its use. Permission to reproduce it in any
other way must be obtained from the Head of Publications. The College
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Please note that we are unable to offer advice on individual cases. Please see our FAQ for advice on getting help.
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