How to help a child with severe anxiety

Supporting A Child With Anxiety | Tips & Advice

What is anxiety?

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

All children and young people feel worried sometimes, and this is a normal part of growing up. At certain points, such as on their first day of school or before an exam, young people may become more worried, but will soon be able to calm down and feel better.

Anxiety can become a problem when a young person feels stuck in it, or when it feels like an overwhelming, distressing or unmanageable experience. 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.

If your child is struggling with anxiety, there are things you can do to help them – including providing emotional support, working on practical strategies together and finding the right professional help if they need it.

What makes young people anxious?

A young person may feel anxious for a number of different reasons, depending on the individual. If your child is feeling unmanageable amounts of worry and fear, this is often a sign that something in their life isn’t right and they need support to work out what the problem is.

The following kinds of things can make some children and young people feel more anxious:

experiencing lots of change in a short space of time, such as moving house or school
having responsibilities that are beyond their age and development, for example caring for other people in their family
being around someone who is very anxious, such as a parent
struggling at school, including feeling overwhelmed by work, exams or peer groups
experiencing family stress around things like housing, money and debt
going through distressing or traumatic experiences in which they do not feel safe, such as being bullied or witnessing or experiencing abuse.

This video by Braive (2m 30s) is a useful way of understanding how stress and anxiety can build up in a person's life.

Symptoms of anxiety

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.

Physical symptoms:

panic attacks, which can include having a racing heart, breathing very quickly, sweating or shaking
shallow or quick breathing, or feeling unable to breathe
feeling sick
dry mouth
sweating more than usual
tense muscles
wobbly legs
irritable bowel syndrome (IBS), diarrhoea or needing to pee more than usual
getting very hot

Thoughts and feelings:

preoccupied by upsetting, scary or negative thoughts
nervous, on edge, panicky or frightened
overwhelmed or out of control
full of dread or an impending sense of doom
alert to noises, smells or sights
worrying about being unable to cope with daily things like school, friendships and being in groups or social situations
worrying so much that it is difficult to concentrate and/or sleep

Coping behaviours:

withdrawing or isolating themselves – including not wanting to go to school, be in social or group situations, be away from parents or try new things
repeating certain behaviours, actions or rituals (often called ‘obsessive compulsive behaviours’)
eating more or less than usual
self-harming

How to help your child in an anxious moment

When your child is in the middle of a very anxious moment, they may feel frightened, agitated or worried about having a panic attack. The important thing to do in the moment is to help them calm down and feel safe.

These strategies can help:

Breathe slowly and deeply together.
You can count slowly to five as you breathe in, and then five as you breathe out. If this is too much, try starting with shorter counts. If it works for them, gradually encourage your child to breathe out for one or two counts longer than they breathe in, as this can help their body relax.
Sit with them and offer calm physical reassurance.
Feeling you nearby, or holding your hand or having a cuddle if it’s possible, can be soothing.
Try using all five senses together.
Connecting with what they can see, touch, hear, smell and taste can bring them closer to the present moment and reduce the intensity of their anxiety. You might think together about five things they can see, four things they can touch, three things they can hear, two things they can smell and one thing they can taste.
Reassure them that the anxiety will pass and that they will be okay.
It can be helpful to describe it as a wave that they can ride or surf until it peaks, breaks and gets smaller.
Ask them to think of a safe and relaxing place or person in their mind.
If you haven’t tried this before, agree with them when they’re feeling calm what this place or person is. It could be their bedroom, a grandparent’s house, a favourite place in nature or somewhere they’ve been on holiday. Sometimes holding a memento of a relaxing place, like a seashell or pebble, can help.
Encourage them to do something that helps them to feel calmer.
This could be running, walking, listening to music, painting, drawing or colouring-in, writing in a journal, watching a favourite film or reading a favourite book.

Remember that everyone is different, and that over time you and your child can work together to find the things that work best for them in these moments.

How to help your child manage their anxiety

Outside of moments when your child is feeling particularly anxious or panicky, there are things you can do over time to help them manage their anxiety and feel better.

A lot of these strategies are about helping your child to understand themselves and find out what works for them. The more confident they feel about helping themselves when things are hard, the more they will believe in their ability to cope – helping to reduce feelings of panic.

Ask them what it feels like in their mind and body, and what things make them feel that way. It can be tempting to dismiss their worries because you want to reassure them, but it’s important to empathise with their experience and validate their feelings. You can find more tips on our guide to starting a conversation.

Starting a conversation with your child

This could include a friendship, a relationship with a family member, their schoolwork or a combination of things. Are there changes that could be made at home or school that would make things easier? If your child is worrying about things that are outside of their control, it might help to name together who is responsible for managing the problem – for example, you might say, “worrying about money is the parents’ job”.

Anxiety might make them feel sick or make their heart race. Getting to know these signs can make them less frightening and overwhelming when they happen. It can also empower them to know when to ask for help or to do something to help themselves.

Your child could try doing exercise, drawing or painting, writing in a journal, watching a favourite film, talking to friends or cooking and baking. These kinds of activities can help them to feel calmer.

Teenagers might like to use a mindfulness or meditation app such as Headspace or Calm. Remember that some people find these activities more helpful than others, so encourage your child to decide what works for them.

It might help your child to write down their worries and put them in a worry box, giving them a physical place where their worries can be ‘held’. Or they might prefer a self-soothe box (see video below), which they can fill with things that help them when they feel anxious – like photos, fidget toys, scented oils and positive quotes. You can find out how to make a worry box by reading our guide for parents.

How to make a worry box: a guide for parents

These are physical exercise, sleeping well, eating healthily, drinking water and spending quality time with loved ones. Regular exercise is particularly important for anxiety because it can help to reduce the symptoms in the body. It doesn’t have to be strenuous – walking or gentle yoga can help.

Reducing or stopping drinking coffee, caffeinated drinks and alcohol can help because these can all trigger the physical symptoms of anxiety.

Even if it’s just for a little while, you can help your child take their mind off their worries by having fun, relaxing and laughing. Activities like playing a sport, sewing or playing musical instruments are great for focusing the mind on the moment.

Some children and young people with anxiety will need professional and specialist help to feel better. They may benefit from a specific diagnosis or a treatment such as medication or talking therapy. You can find more information about this below.

Young people tell us it helps to...

find positive activities you enjoy
think about something you’re looking forward to
do physical exercise
learn mindfulness and yoga
imagine your thoughts leaving your brain and floating off into the sky
keep yourself occupied
have time out
reflect on how you’re feeling
talk to other people you trust
remind yourself you’re not alone – odds are someone in your friendship circle has anxiety or depression too

Finding professional help

It’s a good idea to seek professional support if self-help strategies are not making the situation better and anxiety is affecting your child’s life - for example if they are feeling persistently anxious, often having distressing thoughts, or avoiding things like going outside or speaking to others.

There are different places where you can find help for your child. Your GP, your child's school and considering whether counselling or therapy might help are good places to start.

You can find out more about speaking to GPs, finding a counsellor or therapist, accessing Child and Adolescent Mental Health Services (CAMHS), getting help from your child’s school and finding local services on our guide to getting help for your child.

Getting help for your child

The type of support or treatment offered will depend on your child’s age and the kind of anxiety they are experiencing. Talking therapies such as cognitive behavioural therapy (CBT) can help your child to understand the thoughts and feelings behind their anxiety and find practical strategies to help them cope. You can find out more about different types of talking therapies on our guide to counselling and therapy.

Counselling and therapy

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. Read our medication guide to find out more about the different types of medication your child might be offered.

Understanding medication

You can find out more about speaking to GPs, finding a counsellor or therapist, accessing CAMHS, getting help from your child’s school and finding local services on our guide to getting help for your child.

Getting help for your child

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Where to get further support

Useful helplines and websites

While we take care to ensure that the organisations we signpost to provide high quality information and advice, we cannot take responsibility for any specific pieces of advice they may offer. We encourage parents and carers to always explore the website of a linked service or organisation to understand who they are and what support they offer before engaging with them.

How to Cope With an Anxious Child

When children are chronically anxious, even the most well-meaning parents, not wanting a child to suffer, can actually make the youngster’s anxiety worse. It happens when parents try to protect kids from their fears. Here are pointers for helping children escape the cycle of anxiety.

1. The goal isn’t to eliminate anxiety, but to help a child manage it.

None of us wants to see a child unhappy, but the best way to help kids overcome anxiety isn’t to try to remove stressors that trigger it. It’s to help them learn to tolerate their anxiety and function as well as they can, even when they’re anxious. And as a byproduct of that, the anxiety will decrease over time.

2. Don’t avoid things just because they make a child anxious.

Helping children avoid the things they are afraid of will make them feel better in the short term, but it reinforces the anxiety over the long run. Let’s say a child in an uncomfortable situation gets upset and starts to cry — not to be manipulative, but just because that’s how they feel. If their parents whisk them out of there, or remove the thing they’re afraid of, the child has learned that coping mechanism. And that cycle has the potential to repeat itself.

3. Express positive — but realistic — expectations.

You can’t promise a child that their fears are unrealistic—that they won’t fail a test, that they’ll have fun ice skating, or that another child won’t laugh at them during show & tell. But you can express confidence that they’re going to be okay, that they will be able to manage it. And you can let them know that as they face those fears, the anxiety level will drop over time. This gives them confidence that your expectations are realistic, and that you’re not going to ask them to do something they can’t handle.

4. Respect their feelings, but don’t empower them.

It’s important to understand that validation doesn’t always mean agreement. So if a child is terrified about going to the doctor because they’re due for a shot, you don’t want to belittle those fears, but you also don’t want to amplify them. You want to listen and be empathetic, help them understand what they’re anxious about, and encourage them to feel that they can face their fears. The message you want to send is, “I know you’re scared, and that’s okay, and I’m here, and I’m going to help you get through this.”

5. Don’t ask leading questions.

Encourage your child to talk about their feelings, but try not to ask leading questions— “Are you anxious about the big test? Are you worried about the science fair?” To avoid feeding the cycle of anxiety, just ask open-ended questions: “How are you feeling about the science fair?”

What you don’t want to do is be saying, with your tone of voice or body language: “Maybe this is something that you should be afraid of.” Let’s say a child has had a negative experience with a dog. Next time they’re around a dog, you might be anxious about how they will respond, and you might unintentionally send a message that they should, indeed, be worried.

7. Encourage the child to tolerate their anxiety.

Let your child know that you appreciate the work it takes to tolerate anxiety in order to do what they want or need to do. It’s really encouraging them to engage in life and to let the anxiety take its natural curve. We call it the “habituation curve.” That means that it will drop over time as he continues to have contact with the stressor. It might not drop to zero, it might not drop as quickly as you would like, but that’s how we get over our fears.

8. Try to keep the anticipatory period short.

When we’re afraid of something, the hardest time is really before we do it. So another rule of thumb for parents is to really try to eliminate or reduce the anticipatory period. If a child is nervous about going to a doctor’s appointment, you don’t want to launch into a discussion about it two hours before you go; that’s likely to get your child more keyed up. So just try to shorten that period to a minimum.

9. Think things through with the child.

Sometimes it helps to talk through what would happen if a child’s fear came true—how would they handle it? A child who’s anxious about separating from their parents might worry about what would happen if a parent didn’t come to pick them up. So we talk about that. If your mom doesn’t come at the end of soccer practice, what would you do? “Well I would tell the coach my mom’s not here.” And what do you think the coach would do? “Well he would call my mom. Or he would wait with me.” A child who’s afraid that a stranger might be sent to pick them up can have a code word from their parents that anyone they sent would know. For some kids, having a plan can reduce the uncertainty in a healthy, effective way.

10. Try to model healthy ways of handling anxiety.

There are multiple ways you can help kids handle anxiety by letting them see how you cope with anxiety yourself. Kids are perceptive, and they’re going to take it in if you keep complaining on the phone to a friend that you can’t handle the stress or the anxiety. I’m not saying to pretend that you don’t have stress and anxiety, but let kids hear or see you managing it calmly, tolerating it, feeling good about getting through it.

Video Resources for Kids

Teach your kids mental health skills with video resources from The California Healthy Minds, Thriving Kids Project.

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5 Ways to Manage Children's Anxiety

Anxious children are often depressed and find it difficult to communicate with others because they perceive the world as frightening and hostile. Such children are indecisive, they cannot distinguish the important from the unimportant, constant unrest exhausts them and deprives them of vitality. What to do if your child often worries for no reason, says child psychologist Anzhelika Obedkova.

Anzhelika Obedkova, child psychologist

Anxiety cannot be called a destructive feeling, because in some situations it helps to avoid danger and solve problems. But if this feeling manifests itself in favorable situations and becomes a stable feature of the child's personality, then this is a reason to think.

Find the cause

In childhood, it may not necessarily be caused by external factors. Anxiety can arise due to some problems during childbirth, during the mother's pregnancy. This condition may not leave the child after birth. At the same time, anxiety does not always find its expression in fear and may not be recognized by the child. The difference between fear and anxiety is that fear can be situational or caused by a specific impact from outside. It is easier to deal with it, especially at a younger age, but with anxiety, the situation is much more serious. nine0003

If we are talking about the period of the first years of a baby's life, then the causes of anxiety can be: excessive guardianship, lack of freedom of action, constant control and too emotional reaction of parents. They also include a lack of attention. In this case, the child worries about his safety and does not understand why no one needs him. In some cases, a child may have such feelings after the birth of a brother or sister; rarely, improper parenting practices in kindergarten or school can be a source of concern. nine0003

But if parents provide a sense of security for their child, then he can easily cope with all this. Lack of contact with other children can also affect the occurrence of anxiety. Therefore, parents should socialize the baby before sending him to kindergarten.

How to cope?

It must be clearly understood that the reasons for the appearance of constant increased anxiety in a child are associated, first of all, with the situation in the family. To understand what is happening:

Contact a child psychologist and visit a couple of classes with your child.
If this is not possible, talk to the child about his condition. It should be a casual sincere conversation with an interested listener. It is desirable that this was not one conversation.
Organize activities with your child to make them feel like part of the family. Here you can create a situation of success, in other words, praise to raise self-esteem. nine0003
Try to relieve tension. It can be drawing, listening to calm music before going to bed, bodily contact, including massage of the face, shoulders, back - it helps to relieve tension very well.
And most importantly, don't worry yourself. Children feel it very well and absorb it like sponges. Therefore, if you are worried, then it is logical that the child will experience the same emotions.

If the alarm is situational, then there is a different scheme of action. It is necessary to carefully create a situation of collision with her, then gradually the child will understand that there is no reason to worry. nine0003

Let's look at an example: a child has anxiety because he started going to kindergarten. It can be manifested by tearfulness, poor sleep and appetite, impaired stool, fever, unwillingness to talk about kindergarten, unwillingness to let mother go even to the store. It is important to be consistent here.

There is no need to praise the kindergarten and convince that everything will be fine there, because after such convictions the child will be even more disappointed, it will be even more difficult for him to cope with anxiety. It is better to start visiting playgrounds with him and create situations in which he himself wants to communicate with other guys. You can look at photos of other kids from kindergartens together, and then take a short tour of the kindergarten, see what is happening there. Explain to your child every day why he should stay with other adults for a while. During the week, visit kindergarten together, discussing each passing day. After that, you can invite the baby to stay there for one day without mom or dad. When the child agrees, parents can start leaving him with teachers for half a day. With a good outcome, he will calm down and start attending kindergarten with joy. nine0003

In order to prevent a child from feeling increased anxiety, it is necessary to create and maintain a comfortable harmonious environment in the family. Heart-to-heart conversations at the end of the day, discussing everything that happened, help prevent many psychological problems in children, including anxiety. We should not forget about hugs, joint games with children, about kind words. The main thing is that parents should understand in time what their child is going through.

Text: Anastasia Kuratova

Photo: Tomsickova Tatyana, altanaka / Shutterstock.com

See also:

How to talk to children about death

“Sensitive children become victims of bullying.” Guests of the Oh! Children" told how to deal with bullying at school

3 objective reasons why a child is lazy

15 books that will help develop a child's curiosity

psychologychildrenuseful tipsupbringing

Anxious child - How to help a child cope with anxiety

Children often worry about something unknown or new. And this is a normal reaction to an unfamiliar situation. But only until such a reaction becomes permanent.

It is very important for a parent to try not to anticipate the child's fears, protecting him from all the difficult moments of growing up: this way you can only aggravate the problem. Therefore, it is important to be careful when paying attention to children's anxiety. What to do? nine0003

1. Respect feelings without exacerbating them

It is important to listen to the child: not to minimize his fear, but also not to give him real strength. Figure out together what scares him, try to explain to the child how to resist it. It is important for children to feel that a parent is nearby and will not leave them alone with terrible life situations.

2. Don't avoid "bumps"

Do not avoid fears just because they disturb the child. It won't help in the long run. Does the child begin to worry, get upset and cry because of this? Do not get rid of the situation, but help the child cope with it - in the future this will help to avoid repetitions. nine0003

3. Don't feed your fears

Did a child fall off a bike and hurt his knee? Did the dog scare him? It is important not to overdo it and not force the child to return to a terrible situation again in order to “learn how to cope with it”. But also do not forever ban cycling and communication with animals. Let the child figure out what happened and decide for himself whether to ride again or pet the dog.

4. Ask direct questions

Do not play up and "lead" the child to talk about his worries from afar. This can only throw unnecessary thoughts into the fire of children's anxieties. Encourage your child to talk about his experiences and directly ask for details if necessary.

5. Do not scare the child with reality

Avoiding talking about difficulties is not the best way out. It is better to explain to the child that bad grades, failed friendships, not wanting to go to school are natural and normal situations in life. The main thing is to support him and show your confidence that the child will cope with everything. So he will not only prepare for any "trick", but will also feel your support, regardless of success. nine0003

6. Teach your child to relax

Anxiety comes not alone, but in the company of clamping different muscle groups. Therefore, for restless children, relaxation is a must. A psychologist will help to do this correctly by selecting exercises depending on the level of anxiety of your child. If there is such a need, you can contact the staff psychologist of "Aitigenio" by simply writing about your desire in any of the messengers.

7. Work on your child's self-esteem

For this it is important not only to love, but also to respect the child, to see his dignity and be able to notice all his successes. Even the smallest, at first glance.

8. Make anxiety predictable

When does this pulling feeling occur? When you are in an unfamiliar situation and you just need to be "brought back" back into your comfort zone. Therefore, it is so important to learn how to communicate with her, as with an old and very boring acquaintance.