Health Agenda

Mental Health

Anxiety in children: Small steps to help support kids and teens

Is your child showing signs of anxiety? Here’s how to notice when their fears are more than just normal ‘child worries’ and manage the symptoms.

We all feel anxious sometimes, right? When faced with new, stressful or worrying situations, both adults and children can experience tightening in the chest, a racing heart, sweaty palms and butterflies in the tummy. Most of the time though, these feelings go away fairly quickly.

But for some people, including children and teens, these powerful feelings, fears and worries can become overwhelming and can be hard to manage and get under control.

What causes anxiety in children and teens?

There are clear factors that can cause anxiety; a gene or a history of anxiety in your family or stressful events such as losing a loved one, violence or abuse, regular bullying, family conflict.

Signs and symptoms of anxiety in children

It’s normal for children and teens to experience some level of anxiety as they travel through life’s challenges. These common and ‘normal’ anxieties may include feeling shy and being upset about things that may happen in the future, like being left at childcare or school, worrying about schoolwork or what people think of them.

It’s helpful to let children know that anxiety is the body’s ways of protecting us from threats and danger (the fight or flight response).

But when a child's anxiety stops protecting them and these fears become persistent and cause children to become regularly worried, they may need some support.  

So how do you notice when your child or teen is feeling anxious? It’s not easy, as young people with anxiety can often have strong feelings of fear, worry or nervousness that are tricky to pick up on. And teens can be good at hiding their feelings.

The signs of anxiety in children include:

  • Complaints of physical problems like sleeplessness, headaches, stomach aches and tiredness
  • Avoiding situations that worry or scare them
  • Avoidance of new things, places or people
  • Worrying about the right way to do things
  • Clinging to trusted adults
  • Needing lots of reassurance
  • Regular feelings of nervousness or tenseness
  • Feelings of uncontrollable or overwhelming panic
  • Asking lots of questions repeatedly in new situations (e.g. “What if..?” or “What’s going to happen when...?”)

Types of anxiety

There are different types of anxiety disorders, and some children experience more than one type of condition. For example, anxiety is also a common experience for young people with eating disorders.

Some common anxiety disorders among children and adolescents are:

  • Generalised anxiety disorder (GAD)
    This is more common in school-age rather than pre-school children. Signs include trying to be perfect, worrying lots about different things, finding it hard to focus in school and wanting regular reassurance.
  • Social phobia or social anxiety
    Social phobia usually begins in the mid-teens. Shy or socially inhibited adolescents are more likely to experience social phobia, which is an intense fear of being judged or rejected in social situations such as birthday parties. In the face of a feared social situation, a person with a social phobia may experience blushing, trembling, sweaty palms, nausea, dry throat, stomach pains and other symptoms.
  • Post-traumatic stress disorder (PTSD)
    PTSD is when people have powerful feelings of anxiety, fear, helplessness or dread following a trauma or disturbing event. It’s relatively rare in young children, but in adolescents, signs include self-destructive behaviour, acting impulsively or aggressively and having nightmares or flashbacks.
  • Separation anxiety disorder (SAD)
    Separation anxiety is associated with children being away from their parents or main carers.

    While it’s a normal part of a child’s development to feel distressed about being separated from a parent, this can evolve into a more persistent and serious disorder. If the child’s separation anxiety interferes with their life, if they’re significantly more anxious than children of the same age, or if their separation anxiety persists for a month or more, these could be signs of SAD.

    Some older children may also feel anxious when they’re at school and plead with parents to stay home.
  • How to support anxious children
    It’s natural for parents to want to ‘fix’ or move children through their distressing feelings. But one of the most important things you can do is listen to your child’s fears and acknowledge how they feel. This helps them identify their feelings but also gives them an opportunity to develop and practise coping skills.

    Clinical psychologist Nikita Singh says while anxiety tends to be generated in unpredictable situations, there are practical strategies parents can use when it comes to encouraging your child, such as:
  • Use social stories
    “For children under 10 years it can be helpful to use a social story about what is likely to happen in certain situations,” says Nikita. “If your child is feeling nervous about an event, tell them what they can expect in as much detail as you can to reduce the question marks they have.” This includes explaining who will be at the event, what people might talk about and which activities they might be asked to participate in.
  • Use reassuring language
    Try saying things like, “I’m here for you”, “Can you tell me more about how you feel?”, “Which calming strategy do you want to use?”, “What do you need from me?”, or “This feeling will pass but I know it’s not easy right now.”
  • Normalise anxiety
    “Everyone experiences anxiety and parents can be role models for their children,” says Nikita. “I encourage parents to narrate their feelings of anxiety or worry.”

    For example, if you’re preparing for a job interview, you could say to your child, “I’m feeling nervous because I want to do well, I don’t know who will be there and I’ll have to talk in front of people.” Then Nikita suggests talking through how you’ll manage that anxiety. For example, you may say, “But I’ve practised for the interview, my boss has told me I’m a great worker, so I’m going to count to 10 in my head before I go in and take some deep breaths.”
  • Label the worry
    “It’s helpful for children to externalise their anxiety,” says Nikita. “Parents can help by saying, ‘I can see you’re feeling worried because your shoulders are tense and you’re biting your nails’.” For older children, Nikita suggests asking questions like, “What is your anxiety telling you?” and after an event asking, “Was your anxiety right?”
  • Calm the physical effects
    Your child’s heart may be racing, they may have butterflies in their stomach or nausea, but you can help calm the physical effects of anxiety often without needing medical advice from health professionals. Encourage them to calm their body by breathing in deeply for three seconds, holding for three and letting their breath out for three.
  • Make time to worry
    It sounds counter-intuitive but making time to worry can help. Having time set aside each day to worry can help children work through their feelings. Have a designated ‘worry doll’ they can speak to or encourage them to write their worries on a piece of paper and put it into a ‘worry box’ that’s closed and put away when worry time is up (after about 10–15 minutes).

Need more information or help?

Children’s mental health is important. If you have concerns about your child, you can get professional help from your child’s school counsellor, your GP or paediatrician, a mental health service or a psychologist.

You can also access these expert online resources about childhood anxiety and depression:

Words by Lindy Alexander
First published February 2020

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