Anxiety in Children and Teenagers
Anxiety in children and teenagers is the most common mental health problem reported, for children of all ages. Studies have estimated that between 5 and 10 per cent of children and teenagers meet the criteria for a diagnosis of anxiety disorder.
Managing emotion, particularly worry and anxiety, is a skill which we develop as we mature. Young children, in particular, need a lot of help with this.
What is anxiety in children and teenagers?
Feeling anxious sometimes is normal and healthy. We all need a certain amount of anxiety to spur us on and motivate us. Imagine if we didn’t worry about what our boss said if we didn’t turn up for work. Or if we didn’t care enough to check whether there is a car coming before we cross the road! Anxiety can keep us safe. It actually helps to enhance performance.
Sometimes though, worries get too big or feel out of control. It is only when your child’s anxieties appear to be having a significant impact on their day to day functioning you may need to seek professional help. This might include talking therapy (the first step would be to consult your doctor). For instance, if anxiety stops him from going to school or mixing with friends. They Are The Future aims to help you understand anxiety better. It will offer you simple strategies to help anxious children learn to manage this powerful emotion.
How does anxiety in children and teenagers affect individuals?
Anxiety affects us in four main ways – the way we feel, the way we think, the way our body works and the way we behave. This is at the centre of a type of talking therapy clinical psychologists use, called ‘Cognitive Behavioural Therapy’ (CBT). CBT is a psychological approach which helps children, young people and adults overcome issues including anxiety and low mood.
A Cognitive-Behavioural Approach
Cognitive Behavioural Therapy is based on the idea that how we think (cognitions), how we feel (emotions) and how we act (behaviour) all interact with each other. Negative thoughts cause us distress and make us worry. Often the worry we have is not in proportion, or realistic to the situation. Just imagine for a moment that you are lying in bed and you hear a bang downstairs. If your thought processes are – ‘Oh it’s Alfie the cat again’ you are likely to remain quite calm and go back to sleep. However, if you think ‘oh my goodness, there must be a burglar downstairs’, you may feel fear and panic. You may ring the police. When we are worried our thoughts focus on danger or threat.
Fight or Flight
The way we think and interpret situations impacts how we feel and behave. It also affects how our body reacts. You may have heard of something called the ‘fight or flight’ response (also sometimes referred to as the ‘Stress response’). This is a primitive defence mechanism located in our sympathetic nervous system. It evolved to enable us to react when faced with danger. To run away, to fight, or sometimes freeze in order to keep ourselves safe. A series of bodily changes occur when our fight or flight response is triggered. For example, our muscles tense up (ready to run or fight), the heart rate speeds up (helping to circulate oxygen around the body), and digestion is interrupted temporarily. This is so that blood can be diverted to the arms and legs (which can often make us feel sick or feel “butterflies” in the tummy).
So anxiety in children and teenagers is a normal, healthy response that can help them in certain situations (for example, in real danger). However, the fight or flight response might be triggered too often, by things which they perceive as a threat (such as school tests, going to a party) but are not actually dangerous. A helpful way of explaining it to children is to consider a smoke alarm. A smoke alarm alerts us to a potential fire, but it can easily be triggered by a burnt piece of toast. It cannot distinguish between a fire (a real threat) and smoke from burnt toast (false alarm). When we see certain situations as worrying or threatening, our fight or flight response is still triggered but the response of the alarm is the same. As a result, we feel uncomfortable and geared up as if we are under real threat.
Help your child notice the signs in the body
Children need to understand and ‘tune in’ to their own experiences of the fight or flight response and describe what they actually feel inside their bodies. As they become more aware of the symptoms of anxiety they can see them for what they really are. Symptoms of worry and anxiety in children & teenagers can often be misinterpreted as further reasons for worry (eg ‘My tummy hurts – something is wrong with me!’).
As we become more skilled at spotting the signs that our threat system has been activated, we also have a better chance of being able to ‘nip the worry in the bud’ before it starts to take control.
Anxiety and anger are often connected
Anxiety in children and teenagers can also often manifest itself as anger. As we know, fear triggers the fight or flight response. We may then withdraw into ourselves (flight) or become agitated and angry (fight). As parents, we must figure out whether anxiety could be the cause of some angry behaviours we may be seeing.
Encourage your child not to avoid situations they find scary
It is natural for anxious children to want to avoid things. Why wouldn’t you avoid a situation if you knew it was going to make you feel uncomfortable and distressed? However, avoidance fuels anxiety and keeps it alive. If children continue to avoid the situations they feel worried about they never give themselves the opportunity to prove that they can cope.
Teach your child some simple coping skills – starting with slow breathing
When worries trigger anxiety in children and teenagers, there are some “anxiety hacks” they can use to switch on the more calming system in their body – the parasympathetic nervous system. They will feel more comfortable and relaxed as a result. The most important of these is slow breathing.
Children and young people with anxiety will notice that their breathing speeds up when they are anxious. This is part of the fight or flight response to help get more oxygen into the body. By deliberately slowing the breathing, ensuring your child breathes into their diaphragm (deep in their tummy rather than into the chest), this signals to the nervous system that actually, they are safe. Practise breathing with them: In for 5 seconds and out for 5 seconds. Practise with your child or young person for at least 5 minutes every day. Soon it will become more natural for them as a response to anxiety. Whenever they notice their breathing speeds up, they will think “okay, I need to slow my breathing down”.
In this section will be adding more posts to help you better understand anxiety in children and teenagers, and learn simple strategies and coping skills to teach your child.
With thanks to Dr Sue Wimshurst, clinical psychologist and co-author of Brighter Futures: A Parents’ Guide To Raising Happy, Confident Children In The Primary School Years
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