Supporting children and young people with anxiety
What is Generalised Anxiety Disorder?
It is normal for everyone to feel worried or anxious about something at some point in life. However, for children and young people with Generalised Anxiety Disorder, this worrying feeling is continuous and extreme and often affects their ability to go about their normal daily activities.
Children and young people with Generalised Anxiety Disorder (GAD) have difficulties in controlling their worries about people, situations or events. It may come across that they are overly worried about their family, money, friends, health or an upcoming event, such as an exam, or they may expect the worst possible outcomes for any situation even when there is no reason to believe this will be the case.
Signs that a child may be affected by Generalised Anxiety Disorder
The signs and symptoms for General Anxiety Disorder may differ between individuals, however there are some common symptoms that you may become aware of. These include worrying about things before they happen, worries about friends or family members, refusing to go to school, almost constant thoughts and fears about their own safety or their families safety and lots of worries about sleepovers away from home. Additionally, frequent crying spells and complaints of frequent stomach aches, headaches, or other physical complaints, such as muscle aches or tension, or a lump in the throat, might be observed.
Children and young people with General Anxiety Disorder may also exhibit other behavioural symptoms, such as exhibiting clingy behaviour with family members, sleep problems or frequent nightmares, extreme tiredness (fatigue), often being ‘grouchy’ or irritable, being out of control during emotional outbursts and struggling to concentrate on tasks at hand. They may also be easily startled, frequently need to go to the toilet, not eat properly and struggle to relax even in 'safe spaces' such as at home.In older children, you may also see a lack of confidence in trying new things, lots of negative thoughts that things may go wrong, and avoidance of social activities such as meeting up with friends or family.These symptoms can overlap with many other health and mental health problems, and it is important that your child firstly be seen by their GP. This will help to rule out any other issues before a mental health referral is made to obtain a diagnosis.
Common issues parents and carers may have to contend with
Younger children may not be aware that their anxiety is more severe than that of their peers, so it may be a real challenge for parents and carers and families to help their child open up and find the cause of the anxiety. It may take a while for children and young people to understand that their anxiety is negatively affecting them, and that they need help.
Children and young people with Generalised Anxiety Disorder may also have a low self-esteem and try to avoid situations that cause anxiety, leading to them becoming withdrawn from friends and family. This social withdrawal may not be limited to only social situations but may also include avoiding any new experience in general. Parents and carers may therefore have to contend with strong feelings of failure and may need to constantly provide reassurance and praise for any new attempts a child makes.
There are many different treatment options for Generalised Anxiety Disorder including the use of prescription medication and Cognitive Behavioural Therapy (CBT). Families may therefore be faced with difficult decisions regarding the use of medication for children and young people, as well as the stigma related to a child receiving therapy and requiring medication. As the child or young person with Generalised Anxiety Disorder grows older, the issue regarding the best treatment options may need to be adjusted in order to lessen the feelings of stigma and judgement.
A child or young person’s anxiety may affect many aspects of their daily lives. Given their insecurity about the past, present and future, children and young people with Generalised Anxiety Disorder may require a lot of reassurance from family members. As situations causing the anxiety may be ever-changing, it can feel as though there may be no end to your child or young person’s anxiety. Parents and carers may often feel overwhelmed and frustrated towards the demands that a diagnosis of Generalised Anxiety Disorder places on the entire family, and additional support may be needed to help everyone in the family cope with these feelings.
How to support a child or young person with Generalised Anxiety Disorder
A good starting point to helping your child is to talk together about the things that are worrying them. Show your child that you understand what they are feeling, and that you are willing to listen and help in any way possible. Keep in mind that this conversation may cause anxiety in itself, especially in younger children. Therefore, it is important to keep an open line of communication with your child, and address issues that cause anxiety as they come up.
It is also helpful to work together with your child to try and find solutions for the issues that cause anxiety or worry. It is not always possible, or helpful, to avoid all situations which may cause your child some anxiety. Talk together about the options available to manage a new situation and any feelings that may arise as a result of this new challenge. Instead of ignoring a situation, for example a birthday party, create a plan along with your child to help manage the situation. This gives them a bit of control over this new challenge, helps them to know what to expect from the situation and to know what to do if the situation becomes too overwhelming.
As your child grows older, teach them how to recognise any signs of anxiety as they arise. Teach them how to manage these early signs, such as using relaxation techniques, and when to ask for help from others. Having a good family routine can also be of great help and will help you not to become anxious yourself or too overprotective of your child. If you are aware of a stressful event coming up in your child’s life, it may be helpful to look for books or films that can help them understand the situation better. Using a “worry box” can allow your child to write down things that worry them and ‘post’ it into the box throughout each day. You can then go through these at the end of the day, or at the end of the week and talk through each one. You can find over 90 strategies identified and written by other young people on our Self-care resource.
What to say to schools and colleges
It is important for schools and colleges to recognise that Generalised Anxiety Disorder can harm a child’s emotional and mental wellbeing. Therefore, it is helpful to try and lessen the anxiety surrounding the child or young person as much as possible. Good, open communication between parents and carers and schools is really important to helping your child manage anxiety when you are not around.
Teachers may find that children and young people with anxiety disorders have difficulty in completing their schoolwork. Finding strategies that work at home to also use in the classroom may help to ease some of the child’s anxiety. Providing children and young people with additional time to complete work or assignments and making sure that assignments are written down correctly before they are started, may also be helpful. Reasonable adjustments, such as sitting exams in a quiet room, may also be helpful in helping your child's attainment.
Supporting school attendance by implementing a daily schedule for children and young people may provide structure and lessen anxiety, although modifications to workloads and assignments may still be required. Inclusion of relaxation techniques and frequent breaks in the classroom may provide additional support. Lastly, it is important to be very aware of possible bullying amongst peers and to be aware of your school’s policy on bullying and how they will specifically support your child with both their anxiety and any instances of bullying that might occur.
What to say to siblings
It is important for siblings to understand that the anxiety their brother or sister is experiencing is real, and that they are not simply seeking ‘extra’ attention. This may help to ease any feelings of jealousy towards a child or young person with anxiety and will help siblings to understand the diagnosis a bit better.
It is also important that siblings are aware that they can, intentionally or unintentionally, worsen their brother or sister’s anxiety by teasing or bullying them. Although siblings do tend to tease and bully each other to a small degree, it may be necessary to explain to siblings that this may be very hurtful and discuss with them how their actions can impact on others. The lack of control and feeling of helplessness is a very real thing for children and young people with anxiety and the seriousness of that needs to be communicated to the siblings in order to avoid any rivalry or animosity between them.
What to say to extended family
Firstly, talk to your child about whether they are comfortable with extended family members knowing about their anxiety. It can be a very helpful exercise to sit with your child and decide what to say to extended family members, and to decide what they can do to help you and your child when visiting.
Extended family members should be aware that their presence can initially cause anxiety in children and young people with Generalised Anxiety Disorder. It is therefore important not to have too many expectations from the child or young person immediately. It may be helpful to allow your child to initiate interactions and conversations with extended family members when they feel comfortable enough to do so.It is also important that extended family members not draw unnecessary attention to the anxiety of a child or young person. For example, rather than asking the child directly if they will be too anxious to go out shopping or to a meal, it may be best to ask the parents or carers first and decide how to discuss this with a child or young person after.
Lastly, it is important that extended family members understand the child is not being rude towards them or ignoring them for no reason. They should be made aware that Generalised Anxiety Disorder is a mental health disorder, and that certain arrangements may therefore be necessary to ease the anxiety of the child or young person. However, it is still possible to have lovely, positive interactions between extended family members and children and young people with Generalised Anxiety Disorder, given the right support and patience.
Additional support for parents and carers
The following organisations offer specific support for Generalised Anxiety Disorder:
Anxiety UK - information and support