Supporting your child with anxiety

20 mins read

This advice applies across the UK.

All children and young people feel worried sometimes; it is a normal part of growing up. But anxiety can become a problem when a young person feels stuck in it. Here we look at how to support your child with anxiety.

In this article

What is anxiety?

Anxiety is a feeling of worry or fear. It is experienced through a combination of physical sensations, thoughts and feelings.

All children and young people feel worried sometimes, and it is a normal part of growing up. It is natural for children to feel anxious when they change schools, do an exam, or go into a new situation, for example. Once this situation has passed, the child is able to soon calm down and feel better.

When anxiety takes hold

Anxiety can become a problem when a young person feels stuck in it or when it feels like an overwhelming, distressing, or unmanageable experience. It can make children imagine that things in their lives are worse than they really are, and it can prevent them from confronting their fears.

If this kind of worrying goes on for a long time, it can leave a young person feeling exhausted and isolated and limit the things they feel able to do. It can start to affect their everyday lives. Anxiety can also cause changes in their behaviour, such as becoming overly careful or avoiding things that trigger anxiety.

Natural stress or worry can come and go, but anxiety can persist, whether you know the cause or not. However, it’s important to remember that anxiety is normal and part of our body’s protective system.

What causes anxiety?

Anxiety affects everyone differently and can be brought on by different situations. It’s our body’s natural internal alarm system that’s designed to protect us from danger.

Anxiety enhances our alertness and attention by giving us a boost of adrenaline. This increases our heart rate and the amount of oxygen going to our limbs. This is called the “fight-or-flight response”. It can be triggered in everyday situations when stress or worry has built up, often unknowingly.

The fight-or-flight response comes from caveman times and was designed to help us to either fight, freeze or flee from danger. It is our body’s natural response to danger. It’s also the cause of the “butterflies in the stomach” feeling that’s often associated with anxiety.

Some children can be born more anxious and less able to cope with stress than others. Children can also pick up anxious behaviour from being around anxious people.

Life events can also have an impact, for example:

Children more prone to anxiety

Children with attention deficit hyperactivity disorder (ADHD) and autistic spectrum conditions are more likely to have high anxiety levels. People with these conditions also sometimes “catastrophise”, immediately assuming the worst possible outcome in a situation.

Children with sensory issues may also have high anxiety levels due to triggers in their environment.
Some children naturally react more than others, and there are times when everyone may go through stressful situations and feel anxious because of uncertainty or perceived threat.

You can learn more about sensory issues and how to avoid situations that trigger your child. You may want to use visual aids like now-and-next cards or social stories to predict the day. See the ‘Resources’ section at the end of this page.

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Sensory processing differences

On this page we help you understand and identify sensory processing differences and provide strategies and techniques to support your child.

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Sometimes it can be difficult to know what is making your child anxious. This can be upsetting or stressful in itself. Learning to recognise what is making your child anxious can help so you and they can deal with the uncertainty better.

How does anxiety make you feel?

Anxiety tends to affect a young person’s body, thoughts and feelings. They may also behave differently, including turning to certain coping behaviours to try to avoid or manage their anxiety.

Anxiety affects children in three different ways. They may have:

Physical symptoms

Physical symptoms show up as bodily sensations. These feelings can be overwhelming, but if we recognise them for what they are, it can help. It can also help children to notice the anxiety before it becomes overwhelming. It is really important to help children to notice and understand the feeling in their body as anxiety.

Examples include:

You can talk with your child about their bodily sensations and wonder with them what they feel and where they feel it to help them identify these sensations as anxious feelings. You can draw a picture of a body and ask them to show you where the feelings are.

Psychological symptoms

Psychological symptoms are what you start telling yourself about a situation when you feel anxious. They include:

Behavioural symptoms

These are what we do to cope with the situation. Coping behaviours include:

Charity Young Minds has a video with teenagers discussing anxiety and how it makes them feel.

If your child is autistic or learning disabled

Autistic and learning disabled children may have more trouble identifying, understanding and describing emotions. They may struggle to sense physical symptoms of anxiety, such as changes in heart rate or a rush of adrenaline.

They may also struggle to show or feel emotions that are seen as socially appropriate, such as happiness on a joyous occasion. This is known as “alexithymia”, and it can make anxiety feel worse for the 50% of autistic children it affects. These children may need a different approach to therapy. Find out more about alexithymia and strategies to help from the charity Autistica.

NHS England provides extra support to autistic and learning disabled children experiencing a mental health crisis. This includes measures to keep them safe and out of hospital or making sure they are supported properly when discharged.

If your child has a special interest or has “stimming” behaviour that helps calm them, you can allow this if it’s harmless.

It is important to check with your GP to rule out any physical illness.

Creating a mapping chart

Write out together what you think the physical, psychological and coping behaviours may be for your child’s anxiety.

If it helps you could create a visual mapping chart, for example putting your three lists into a pie chart.

What are the signs of anxiety?

Anxiety can show in a variety of ways. This can be as changes in your child’s body, feeling constantly worried, or changes in their behaviour, such as becoming overly careful or avoiding things that trigger anxiety. It may not be the same signs every time, and every person is different.

Bedwetting, separation anxiety and bad dreams are very common in young children. Teenagers tend to have more social anxiety with worries about school and friendship groups. It is common to misread symptoms of anxiety as physical symptoms, particularly for neurodivergent children.

Common signs that your child is anxious include:

Types of Anxiety

This list is not exhaustive:

You can find out about different types of anxiety at charity Anxiety UK.

How can I help my child?

Keep an eye out for changes in behaviour. Be understanding that this change in behaviour is part of the anxiety and understand your child’s feelings.

You can keep a diary of physical symptoms, psychological symptoms and coping behaviours. You can take this to your GP to ask for support.

See our information and parent guides on bedroom routines and helping your child sleep and feeding and eating, plus understanding your child’s behaviour, which are full of tips and strategies to help.

Communicating well

Good communication helps your child feel safe and less anxious. Find a time when your child is relaxed and willing to talk, like bath time or meal time. Be judgement-free and help them to recognise how they are feeling.

Sometimes anxiety can be a false alarm, so find out if there is a real fear. If, for example, they feel they are being bullied or they’re falling behind at school, their anxiety is real and is protecting them. If their anxiety is a false alarm, then you can give them tools to manage their worry.

Listening questions

Ask “listening” questions, like:

You can think with your child about how anxiety gets in the way of them having fun.

Communication style

What can help:

Acknowledging and naming the feeling

As parents we want to take the worry away, but we need to acknowledge it and not dismiss it.

Acknowledging and naming the feeling is always important, even if we can’t take it away. For example: “Oh, I wonder if you are feeling scared,” or “Maybe this is making your heart race; perhaps you are worried.” This is much more helpful to children than “Don’t worry”. If your child tries to minimise what is going on for them, you can also say, “It’s not silly if it’s making you feel like this.”

Sometimes you can also help them with a fear (even if you don’t understand it), like checking for monsters under the bed.

Externalising the anxiety

Naming your child’s feeling and making a character – for example, Mr Worry or Worry Monster – will help remove worries from your child. You can help your child draw the character, and we then become a team working together to become bigger than Mr Worry.

This means the child feels supported and gives them a chance to understand their worry safely without shame or embarrassment. It also allows us to draw and laugh while we work together. It can also help parents say “No” to the worry, as it is different to saying “No” to the child.

Rating anxiety

It can be helpful for your child to rate their fear from one to 10. Help them understand the strength of the feeling and then work out together how you can make the feeling a smaller number.

Ideas to help manage anxiety

Facing fears using a worry ladder

Anxiety makes you want to run away, but this only makes anxiety BIGGER. The only way to beat anxiety is to face it, but in small chunks. This can help build children’s confidence gradually. You can encourage your child to think of it like climbing the steps of a ladder.

To make a worry ladder, draw a ladder and write the fear your child is facing at the top. Then for each step of the ladder, write down one thing they can do to face that fear head-on. Start with the easiest thing they can do at the bottom rung and work up the ladder together, only moving on when they have a few repeated successes. Reward them for each step they take.

Energy accounting – for autistic teenagers

The idea of energy accounting is to work out what gives or takes away a child’s energy – what is easy and what is more difficult for them to manage in their day. For example, going to a busy supermarket may take a lot of energy and trigger anxiety for an autistic child. Spending time watching a favourite film will give energy back and recharge their battery.

The aim of this is to help children to manage their energy by making sure they are not doing too many of the things that could lead them to becoming overwhelmed, anxious or exhausted.

The National Autistic Society has an energy accounting guide, which explains different ways you can help your child do energy accounting.

Calming techniques

Allow time for special interests if possible, which can be a place of safety for your child. Here are some more ideas to try:

Visualisation exercise

You can help your child imagine their favourite relaxing calm place. This can calm anxious feelings. Help them to sit, shut their eyes and think of a lovely, calm place. This could be a real place you have been to or a picture they may have created in their dreams.

Choose a quiet time when you won’t be disturbed and guide them to:

You will need to practise this with your child. The more you practise, the easier they will find it to imagine their picture, and the quicker they will become calm. Tell them whenever they feel themselves becoming stressed to think of their calming picture.

Mental health support for children

If things are not getting better and you’re concerned about your child, it’s time to seek professional help. You can speak to a teacher or school nurse, your GP, a youth worker, a social worker or your child’s doctor. They will know what support is available locally and can refer you in the same way a GP can.

You can also ask your child’s school if they have a Trailblazer or Place2Be scheme. These are free mental health support teams in schools. They provide early-intervention wellbeing support for children, young people and their parents dealing with issues like anxiety, challenging behaviour, and friendships.

Help that may be offered

Your child may be referred to:

Referals to CAMHS usually prioritise seeing children and young people they feel are in most urgent need. Waiting lists can be long. In the meantime, talk to your child, their teachers, your GP or others involved about strategies to help them while waiting.

Medication may be offered if your child’s anxiety is very difficult to manage or talking therapy has not helped. Medication should be suggested alongside talking therapies or another psychological treatment and by a doctor who specialises in children’s mental health. Find out more about medications at Young Minds.

Resources

Websites

Apps, text support and social stories

Books

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