Anxiety

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It’s normal for our children to feel nervous, anxious or worried from time to time about stressful, for example, starting school, a parent being unwell or moving to a new area.

Some level of anxiety is helpful, to help us stay safe or to motivate us to make a change. However, when anxiety goes on for too long, feels overwhelming and starts interfering with parts of daily living, then young people might need additional support.

Anxiety can involve having lots of worried thoughts that can be difficult to switch off from. They can be worries about current circumstances as well as concerns about potential future events. These worries can feel even more difficult and overwhelming when our bodies have physical responses to stress (‘fight/flight/freeze response’), which is the body’s way of reacting to perceived threats. Adrenaline is released which can lead to feeling short of breath, a racing heart, shaking, feeling out of sorts and struggling to concentrate. Although this response is safe it can feel distressing. Feeling anxious can understandably make young people want to avoid stressful situations that feel overwhelming and may want to stay home where it feels safe, but by not facing fears in a manageable way anxieties become bigger and young people lose confidence. Anxiety can also lead to feeling irritable, feeling down and panicked.

What causes it?

Anxiety can be a build-up of lots of different factors that make this emotion feel overwhelming. Stressful circumstances at home or at school where a young person might feel out of control or uncertain can impact anxiety. Worrying about family members’ welfare and health can play a part. Parental mental health difficulties can also impact young people’s mood. Difficult relationships at school, bullying, and struggling with academics without the appropriate support can also contribute to feeling overwhelmed. Big or sudden life changes can be stressful on the whole family and everyone’s capacity to support one another, which can leave children feeling like they don’t know what to do. Lack of consistency in routines, lack of availability of adults to notice and help when a young person is anxious, and lack of opportunities to boost a child’s self-esteem all can lead to young people struggling with anxiety.

It is estimated that one in six children will experience some form of an anxiety condition growing up. Anxiety can affect infants and children at any stage of their development. There are different forms of anxiety which can be classified into different difficulties, such as:

  • Generalised anxiety (worries including multiple concerns such as home and school)
  • Social Anxiety (worries specifically about social situations and perceptions of others)
  • Obsessive Compulsive Disorder (intrusive and distressing thoughts that people feel an overwhelming urge to complete a behaviour to stop the thought/feeling from happening)
  • Panic Attacks (fears that the body’s natural fight/flight/freeze response might be more threatening and lead to a distressing event, such as a heart attack, going crazy, feinting or dying)
  • Health anxiety (fears about one’s own health or that of a family member)
  • Separation anxiety (fear of being separated from a care giver because of concerns about the caregivers welfare or their own)

What helps?

Talking to children: Talking to children with empathy about how they are feeling. Being curious and helping young people make sense of their emotions. Reminding children they are cared for and that you are there to help. Not dismissing any thoughts or feelings, but making children feel heard and their reactions are valid and that they are safe. Try to stay as calm as you can so you can contain their emotions.

Managing distress: If our child is distressed helping to sooth them by offering reassurance, talking in a calm and kind way. Often when we are stressed the brain struggles to think logically (own ‘emotional brain is switched on’), therefore we need to first calm our brains down before we think about problem solving or any other practical issues. Offering hugs, helping young people breath to regulate the body and help calm down the adrenaline response, staying close to the young person, and using distraction if necessary. Often brining a young person’s attention away from distressing thoughts to things they can focus on in the here and how can help create space between them and the emotion; e.g. using the five senses to bring their attention into what you are doing.

Problem solving: Once we have talked about our child’s experience and helped bring down their emotional response (and switched their ‘thinking brain’ on) then we can think practically with young people about if there are any solutions to their worries. Help them think about options and plan how to address any issues.

Boost confidence: If children have self-confidence they can feel more able to tolerate anxiety and do things that might feel outside their comfort zone. We as parents need to create opportunities to make our children feel admired, that they are achieving at what they are good at, and to feel like they are worthwhile. Also showing unconditional love and positive regard is important (i.e. they are cared for no matter how good or bad they are). Helping to instil positive self-image is vital, and this is done through us spending quality time with our children.

Relaxation: Taking time to help our children wind down. This can be at any time of the day, but often having relaxing things at the end of the day can help aid with restful sleep. This can involve soothing activities and mindfulness, for which there are lots of resources and apps. Getting out for walks in nature as a family and having ‘problem-free time’ also are really helpful to unwind and feel connected.

Gradually facing fears: Reducing avoidance and gradually reintroducing children into situations that initially feel stressful (so they don’t feel overwhelmed) can help children realise that they are more able to tolerate anxiety.

What CAMHS can do to help

CAMHS can complete an assessment with you and your family to help understand where your child’s anxiety may have come from and what are the factors that may be keeping it going. Putting all these pieces of the jigsaw together can then help understand why a young person might feel a certain way (we call this a formulation). Based on this individual understanding/formulation we can decide what is the best fit; whether it is support at school, was to help parent an anxious child, offering advice or referring to more appropriate services or offering therapy to the young person and the family. It is important that everyone is on board and willing to make change and put in effort for CAMHS input to work.