Anxiety

Phobias

It is common to have fears as you grow up, for example being scared of animals or of the dark. These types of fears are thought of as ‘ordinary fears’ that are a normal part of growing up. Usually, children and young people grow out of these fears without any help.

A phobia is different, it is an extreme fear which causes you a lot of distress and has a significant impact on your life. For example, a fear of dogs would be called a phobia if it meant that you avoid going to the park.

Phobias (unlike ordinary fears) tend not to go away on their own, but there are treatment options if you need them.

Generalised anxiety disorder

You might feel anxious a lot of the time and become easily worried. For some people, this is a part of their personality and they have learned to cope well with these feelings. However, generalised anxiety disorder can cause you to worry more than usual and experience severe anxiety which gets in the way of your everyday life.

Symptoms and effects of generalised anxiety disorder can include:

• problems concentrating, which can make it harder to manage school or other day-to-day activities
• not wanting to go to school or be with other people
• finding it hard to relax
• difficulty sleeping
• physical symptoms, such as headaches or abdominal pain

Separation anxiety disorder

Anxiety about being away from your parent or carer is a normal part of childhood. It usually lasts until your pre-school years and can sometimes make going to bed, your parents or carers leaving for work or settling in at nursery or school difficult. However, usually children and their parents or carers are able to manage these difficulties and the level of anxiety fades over time.

Separation anxiety disorder involves anxiety that is more extreme than normal separation anxiety, or when you still experience separation anxiety at an older age than usual. You might often worry or have nightmares that your parents, carers or yourself might get hurt when you aren’t together. You could have separation anxiety disorder if this anxiety interferes with your everyday life.

Separation anxiety disorder is more common in young children (5–7 years) but can happen at any point in childhood, including in your teenage years.

Social anxiety disorder

Social anxiety can look like an extreme type of shyness. You might not be anxious around people you know well, only with people you don’t know as well or in larger groups of people.

This might mean that you avoid situations where you could come across people you don’t know well. You might often also feel anxious around groups of people and try to avoid these situations too. Many young people describe having a fear of embarrassment or humiliation in these situations.

This might cause you problems with making new friends, being in groups, or at school (such as speaking in class).

Social anxiety disorder often develops in your later pre-teen or teenage years, particularly after you have gone through puberty.

Panic disorder

A panic attack is a sudden sense that something terrible is about to happen even though there is no obvious threat, or where your sense of fear is out of proportion to the threat.

There are physical symptoms, such as:

• feeling your heart beating very fast
• feeling short of breath or finding it hard to breathe
• feeling like you’re choking
• sweating
• dizziness
• feeling sick

These physical symptoms can make you feel faint or like you could be having a heart attack.

Panic disorder involves repeated episodes of panic. This can mean that you try to avoid situations where you have experienced a panic attack before, in case you experience panic attacks there again. Panic disorder is rare when you’re a child and tends to develop in your later pre-teen or teenage years, or in young adulthood.

Agoraphobia

Agoraphobia involves feeling anxious about being in places or situations where it might be difficult or embarrassing to escape. These types of fears can involve situations such as being outside your home alone, being in a crowd or using public transport.

If you have agoraphobia you will often feel anxious about a group of similar situations, rather than just one specific situation. For example, if you’re anxious about being in a crowd then you might feel anxious about situations such as school assemblies or going to the cinema.

People with agoraphobia can also often have panic attacks.

Anxiety symptoms and other mental health conditions

Anxiety symptoms can also happen as part of another mental health condition, such as psychosis or bipolar disorder. However, if you have another mental health condition but your anxiety symptoms are separate, then you might be diagnosed with an anxiety disorder as well as your other mental health condition.

Anxiety disorders often happen alongside other conditions. For example, if you have autism or ADHD then you could be more likely to develop an anxiety disorder. Also, if you have an anxiety disorder then you are more likely to experience depression, it is common to experience a mixture of anxiety and depression symptoms.

Some people with anxiety disorders try to cope by using drugs or alcohol, but this can become unhealthy and lead to alcohol misuse or substance misuse.

How can I get help?

If you have problems with anxiety there are different ways of getting help:

• If you are at school then you could speak to a staff member there. Depending on where you live, there might be mental health professionals linked to your school.
• You could also talk to your GP about your anxiety symptoms.
• In some areas you can contact your local child and adolescent mental health service (CAMHS) directly.

You can find more information about mental health referrals here and more information about local mental health services here.

Planning treatment

The first steps when you meet your mental health professional will be to figure out whether you have an anxiety disorder and whether you might have any other mental health conditions. Your assessment will involve talking to your professional about what makes you feel anxious, your symptoms and how your anxiety disorder is affecting you and your family.

If you have an anxiety disorder then you should be offered cognitive behaviour therapy (CBT), which should be adapted for your age. This might involve sessions with your parents or carers.

There are different types of CBT, including the following:

• Individual CBT with a therapist, which might include some sessions with your parents or carers. This can be in-person or online.
• Group CBT where a group of young people with similar difficulties have CBT together.
• Computerised CBT is a CBT programme that you and your parents or carers can work through together.
• CBT by parents or carers, where your parents or carers are given a programme to work through with you.

The choice of how you have CBT should depend on your and your parents or carers preferences, the types of CBT you will find it easiest to take part in and the type of anxiety disorder you have. You can find more information about how treatment decisions are made here. 

Your professional might suggest that you have counselling, which involves one-to-one sessions with a counsellor. Counselling isn’t a specific treatment for anxiety disorders, but can be helpful to work out what you’re anxious about. Some counsellors might also be able to offer you CBT. If during counselling it becomes clear you have an anxiety disorder and the counsellor is not able to offer you CBT, they should refer you to someone else so you can start CBT (this is usually someone based in CAMHS).

You might be offered a type of medication called SSRI (selective serotonin reuptake inhibitor) medication if you have a severe anxiety disorder and CBT has not been helpful, or if you do not want CBT.

What about my parents or carers?

Your parents or carers could play an important role in your treatment, for example, some types of CBT involve parents or carers directly in the therapy. As facing your fears and anxieties can be hard, having support from your parents or carers can be very helpful. This doesn’t mean that your parents or carers will know everything that happens in your individual sessions. You can find more information about confidentiality and privacy here.

The wellbeing of your parents or carers is important, and they may need support and advice themselves. Your professional should help them to access any support they need, which could include:

• emotional support
• practical support with your care
• planning in case of emergencies

Additional support

The below organisations offer anxiety specific support for children, young people and their families:

• AFC Crisis Messenger: a free, confidential, 24/7 text message support service for anyone who is feeling overwhelmed or is struggling to cope. If you need support, you text AFC to 85258.
• Anxiety UK: charity offering support to those affected by anxiety including text and telephone support
• Charlie Waller: charity offering resources for young people affected by anxiety and/or depression
• Childline: Childline is there to help anyone under 19 in the UK with any issue they’re going through. Whether it’s something big or small, their trained counsellors are there to support you
• No panic: charity that helps and supports those living with Panic Attacks, Phobias, Obsessive Compulsive Disorders and other related anxiety disorders
• Supportline: charity offering helpline for people of all ages on a wide range of issues including anger, eating disorders, self-harm, depression, anxiety, panic attacks, and addictions
• The Mix: support and advice for children and young people under 25

Treatments outlined on these webpages may not be available in every local area. It’s important that you discuss with your GP or mental health professional the treatment options available to you. You can also search for services near you on our Youth Wellbeing Directory and find out more about referral processes here.