Tip Sheets - Anxiety

Information sheet for parents and carers.

What is Anxiety?

Everybody experiences anxiety sometimes, especially when faced with unfamiliar, dangerous or stressful situations.[1] Anxiety is a normal response to a perceived threat, and includes physical, emotional and mental responses such as an increase in adrenalin, feelings of worry and confusion, and thoughts about danger and catastrophic outcomes. Normal levels of anxiety can assist people to be more focused and motivated, and to solve problems more efficiently. However, chronic or high levels of anxiety can reduce a person's capacity to respond appropriately or effectively to stressful situations or even normal routine activities. For example a highly anxious person may experience constant physical feelings of panic and may seek to avoid anything that might trigger their anxiety (such as being alone, going to school, talking in front of a group).

This hot topic aims to help parents and carers understand anxiety problems and provide some ideas for parents to support a child experiencing high levels of anxiety.

Anxiety triggers

Anxiety may be triggered in many different ways. Sources of anxiety may include (but are not be limited to):[2][3]

  • fear of social situations
  • fears of negative evaluation and rejection[4][5]
  • fear of performing in public
  • fear of a specific object or situation(e.g. storms or lightning/thunder, insects, blood)
  • fear of being separated from a parent/carer
  • fear about a parent/carer being harmed
  • fears of harm to self
  • fears about academic performance and exams
  • fears about starting school or work
  • generalised fears about the future (what will happen, how it might turn out)

How to tell if a young person is anxious

Anxiety may manifest as a number of physical symptoms including:[3][6][7]

  • muscle tension
  • shaking/ trembling and heart palpitations
  • sweating/ flushing or feeling very hot or cold
  • feelings of choking
  • feeling faint or dizzy
  • rapid breathing, feelings of shortness of breath, or breath holding
  • difficulty concentrating
  • restlessness
  • being easily startled
  • severe blushing
  • numbness or 'pins and needles' in arms and legs
  • recurring headaches, stomach aches, backaches
  • fatigue
  • sleeping difficulties
  • going to the toilet more frequently

In addition, children and young people experiencing anxiety may display a number of behavioural symptoms including:

  • clinging to parents (young children)
  • tantrums (young children)
  • refusing to go to school
  • withdrawing from friends and family
  • avoidance of particular object/situation
  • being a perfectionist
  • being excessively slow
  • shyness
  • substance misuse
  • seeking reassurance
  • negative thoughts or pessimism

Impacts of Anxiety

When a young person is quiet and compliant, anxiety symptoms may be overlooked. As a result, they may not receive the help and support they need, which may lead to increasing problems with anxiety in adolescence and adulthood. As symptoms of anxiety become more entrenched and chronic, an anxiety disorder may develop. Research shows young people with untreated anxiety problems may:

  • perform poorly in school
  • miss out on important social experiences
  • experience depression and relationship problems
  • engage in substance abuse

Anxiety also often co-occurs with other disorders such as depression, eating disorders, and attention-deficit/hyperactivity disorder (ADHD).[8]

Different types of anxiety disorders

While most of the anxiety that children and young people feel is relatively mild, some children and young people may have chronic anxiety or disorders which may require specialist attention.

When the anxiety experienced by a young person starts to affect their general functioning, they may not just be feeling stressed - they may be suffering from an anxiety disorder.

Anxiety disorders are considered serious mental health problems and are one of the most common types of mental health concerns for children and young people.[9][10] Anxiety disorders are so common that one-in-four people will experience one or more anxiety disorders during their lifetime. The anxiety disorders include:[9][10]

  • Generalised Anxiety Disorder (GAD) - Excessive and persistent anxiety about events and activities related to work, study, health, finances, family issues or other general concerns. People who have GAD have difficulty controlling worry, and the associated physical and emotional symptoms such as restlessness, fatigue, difficulties in concentrating, muscle tension and sleep disturbance. GAD affects approximately 5% of people in Australia at some point in their lives
  • Panic Attacks and Panic Disorder - Panic attacks include multiple physical and cognitive anxiety symptoms in the absence of an external threat. A panic attack can include shortness of breath, accelerated heart rate, trembling, sweating, dizziness, fear of going crazy or dying. Fear of panic attacks in public places may lead to agoraphobia. Panic disorder is recurrent and unexpected panic attacks and persistent fears of repeated attacks.

    Approximately 30% of people in Australia will experience at least one panic attack at some point in their lives. Around 3% of the population suffer from panic disorder
  • Obsessive Compulsive Disorder (OCD) - OCD is recurrent and persistent thoughts, impulses or images that are intrusive and unwanted (obsessions), and repetitive and ritualistic behaviours or mental acts that are time consuming and distressing (compulsions) e.g. fears of contamination or harm to self or others; excessive hand washing, showering, checking, or repeating routine actions. OCD affects about 3% of people in Australia at some point in their lives
  • Post Traumatic Stress Disorder (PTSD) - PTSD may develop after exposure to a distressing and traumatic event or ongoing traumatic situation. Recurrent thoughts, images and nightmares of the trauma occur, as well as changes in mood. Other symptoms include emotional reactivity, memory and concentration difficulties. Around 8% of people in Australia are affected by PTSD at some point in their lives
  • Social Phobia - anticipatory worry and avoidance of social and performance situations, due to fears of scrutiny and judgment by others, and fear of behaving in a way that is embarrassing or humiliating. Physical anxiety symptoms commonly occur
  • Specific Phobia(s) - this is when a person feels excessively fearful of a particular thing or type of situation. Phobias can start at any age and a person may have more than one phobia. Common phobias include:
    • claustrophobia or fear of small spaces such as fitting rooms
    • zoophobia or fear of animals
    • acrophobia or fear of heights such as flying

Suggestions for parents/carers

Learning to manage anxiety is an important life skill. The following are some ways in which parents/carers can assist children and young people to handle anxiety:

  • Support them to challenge underlying beliefs and thoughts - negative and irrational beliefs and thoughts such as, 'if I don't look perfect, no one will like me', or 'I can't cope with difficult or scary situations', are significant factors in generating anxiety. Model and communicate effective ways to question and challenge anxiety provoking thoughts and beliefs
  • Support them to accept uncertainty - uncertainty is one thing that people worry about a lot because of the potential for negative outcomes. As it is impossible to completely eliminate uncertainty, you can assist children and young people to be more accepting of uncertainty and ambiguity[11]
  • Be a role model - if you can manage your own anxiety, young people will see that it can be managed and incorporate your strategies into their own behaviours. Teaching parents to manage their own anxiety has been shown to be helpful in reducing their children's anxiety[12]
  • Be patient - sometimes the behaviours of anxious children and teens may seem unreasonable to others. It is important to remember that an anxious young person who cries or avoids situations is, in fact, responding instinctively to a perceived threat.[2] Changing avoidant behaviours takes time and persistence[13]
  • Balance reassurance with new ideas - when your child comes to you with something they are worried about, listen and understand what is happening. Explore with them what they could do to manage their fears
  • Show children and young people some simple relaxation techniques - deep breathing, progressive muscle relaxation and meditation can be helpful as a way of learning how to better manage physical anxiety symptoms. Generally these techniques are only effective if practiced consistently over several weeks
  • Encourage plenty of physical exercise and appropriate sleep - when people are well-rested and relaxed, they will be in a better mental state to handle fears or worries[12][14]
  • Moderate the consumption of caffeine and high sugar products - caffeine products including cola and energy drinks increase levels of anxiety as they cause energy levels to spike and then crash. This leaves a person feeling drained and less able to deal with negative thoughts[14]
  • Make time for things that your child enjoys and finds relaxing - these could be simple things like playing or listening to music, reading books or going for walks[2]
  • Help them to face the things or situations they fear - learning to face their fears and reduce avoidance of feared objects and situations, is one of the most challenging parts of overcoming anxiety. Facing fears usually works best if it is undertaken gradually, a step at a time
  • Encourage help-seeking when needed - make sure that children and young people know there are people who can help if they find that they can't handle a problem on their own. Knowing that they can call on others for support if needed will make them feel less anxious about what might happen in the future[12]
  • Ask for a referral from your GP - you may have to do this if you suspect your child is suffering from an anxiety disorder. By assisting children and young people to learn effective ways to handle anxiety, you can ensure that they are able to deal with it later in life

Who can I contact for more information?

If you have any concerns about your child and their ability to cope with anxiety, you can call Parentline on the phone numbers below:

  • Parentline Queensland and Northern Territory - 1300 30 1300
  • Parentline Victoria - 13 22 89
  • Parent Helpline South Australia - 1300 364 100
  • Parent Line New South Wales - 13 20 55
  • Parent Help Centre Western Australia - (08) 92721466 or 1800 654 432
  • ParentLink ACT - (02) 6205 8800

Resources that may be of use

References

  1. Raising Children Network. (2010). Anxiety in Adolescence. Retrieved from: http://raisingchildren.net.au/ on 20 June 2011.
  2. Good To Know: 10 Things Your Kids Worry About. Retrieved from: http://www.goodtoknow.co.uk/ on 2 March 2010.
  3. Helping Kids Handle Worry. Retrieved from: http://www.education.com/ on 2 March 2010
  4. Connolly, S. D. & Nanayakkara, S. D. (2009). Anxiety Disorders in Children and Adolescents: Early Identification and Evidence-Based Treatment. Psychiatric Times, 26 (10), 40-50.
  5. Laing, S. V., Fernyhough, C., Turner, M. & Freeston, M. H. (2009). Fear, Worry, and Ritualistic Behaviour in Childhood: Developmental Trends and Interrelations. Infant and Child Development, 18, 351-366.
  6. Worry Wise Kids. Retrieved from: http://www.worrywisekids.org/ on 2 March 2010.
  7. Help Guide: Anxiety Attacks and Disorders. Retrieved from: http://www.helpguide.org/ on 2 March 2010.
  8. Hall, W., Lynskey, M. & Teesson, M.(2001). What is comorbidity and why does it matter? Retrieved from: http://www.comorbidity.org.au/ on 24 June 2011.
  9. Australian Institute of Health and Welfare. (2011). Young Australians: their health and wellbeing 2011. Cat. no. PHE 140. Canberra: AIHW. Retrieved from: http://www.aihw.gov.au/ on 21 June 2011.
  10. beyondblue. (2009). Types of Anxiety Disorders (Fact Sheet). Retrieved from: http://www.beyondblue.org.au/ on 21 June 2011.
  11. Help Guide: How to Stop Worrying. Retrieved from: http://www.helpguide.org/ on 2 March 2010.
  12. Khanna, M. S. & Kendall, P. C. (2009). Exploring the Role of Parent Training in the Treatment of Childhood Anxiety. Journal of Consulting and Clinical Psychology, 77 (5), 981-986.
  13. Emotional Health Clinic. (n.d.). Treatment of Child Anxiety. Retrieved from: Retrieved from: http://www.emotionalhealthclinic.com.au/ on 23 June 2011.
  14. Edwards, J. (2009). Physical Activity and Test Anxiety. School Science and Mathematics, 109 (1), 5-6.

Published: 2 March 2011
Updated: 17 November 2011