Anxiety in Children

Our approach to treating anxiety 

Recognising the signs of anxiety in your child can be challenging. You might sense something is wrong, but feel lost and confused trying to pinpoint the underlying issue. Fortunately, anxiety is treatable and seeking support is the first step in reducing the distress your child and your family have been managing alone. Our team of highly experienced child psychiatrists and psychologists have helped many children make a full recovery.

We understand that finding the right support for your child isn’t always straightforward. At the London Psychiatry Clinic, we combine personalised care with specialist knowledge to treat your child's anxiety in the most effective and compassionate way possible. 

Here’s what our approach looks like: 

• Our clinic prioritises creating a welcoming atmosphere, ensuring your family feels understood and comfortable in discussing any challenges.
• We carefully match you with the right specialist, ensuring their training and experience align with your child's needs.
• Before booking an appointment, we can offer a complimentary introductory call, allowing you to decide for yourself if you feel comfortable talking with the specialist.
• We will carry out a standardised assessment that follows the latest clinical guidelines. The assessment is also customised to your child's situation to ensure we don't miss out on any subtle signs of anxiety. 
• If we diagnose anxiety, we develop a personalised treatment plan and share available options with you. This plan uses an integrated approach to help your child achieve their full potential, improving their overall well-being, social skills, and school performance. 

What is childhood anxiety?

Anxiety in children is when they feel more worried or scared than usual. It's normal for kids to feel anxious sometimes, but if these worries are very strong, last a long time, or stop them from doing everyday things like going to school or playing with friends, it might be an anxiety disorder. If you notice your child often seems very anxious and it's affecting their daily life, it could be a sign to get some help from a professional.

How common is anxiety in children?

Anxiety is the most common mental health problem affecting children and teenagers. Childhood anxiety affects 15-20% of children and teenagers, with one in five developing an anxiety disorder. It's more common in girls.

Checklist of childhood anxiety symptoms

Children may often not know they’re feeling anxious. This can lead to unexpected changes in their mood and behaviour including: 

• Difficulty sleeping or waking up from bad dreams 
• Physical complaints, such as tummy aches, upset stomach and headaches
• Avoiding everyday situations, such as school, social events, friends and sports
• Eating more or less than usual
• Sudden or intense reactions such as anger, frustration, tantrums, or meltdowns
• Being preoccupied or struggling to concentrate
• Seeking reassurance with worries and fears
• Planning and thinking more than necessary 
• Feeling self-conscious and nervous 

In teenagers, the symptoms might also include:

• Using alcohol or drugs
• Feeling hopeless about life 
• Social isolation and withdrawal
• Refusing to go to school
• Self-harm or suicidal thoughts
• Frequent panic attacks

But there's good news: We've seen many children overcome these hurdles. Our specialists will tailor their approach to fit your child's unique needs. Together, we'll find the best strategies (therapy, medication, or a mix of both) to support your child.

Types of Childhood Anxiety 

Anxiety disorders in children can show up in complex and different ways. If you think your child or teenager has anxiety but don't know which type they have, don't worry — we're here to help.

Generalised Anxiety Disorder (GAD) 

Generalised anxiety is a persistent type of worry and fear about a range of situations. This worry is excessive compared to the average child and is often focused on the future. It's a generalised type of anxiety rather than worry about a specific issue. Children and teenagers with GAD may overthink their homework, seek reassurance, or strive for perfection.

Separation anxiety

Separation anxiety is an excessive fear of separation from a parent or another caregiver. It’s common in children but not so much in teenagers. Children with separation anxiety will refuse to attend school or cling to you. Physical symptoms include nightmares, headaches or stomach aches. 

Panic Attacks (Panic Disorder)

A panic attack is a sudden, overwhelming and intense state of anxiety and panic. It may occur even when there is no real danger. Symptoms include a racing heartbeat, faintness, shortness of breath, or choking sensations. 

A panic disorder is when panic attacks occur often and for more than a month. Children may avoid places that can trigger a panic attack and may develop a fear of the panic attack itself. 

Phobias 

It’s common for preschoolers to fear things like spiders, barking dogs, storms, and the dark. But these fears usually go away on their own. In contrast, phobias are an overwhelming, irrational fear of a particular place, object, or situation. For instance, a child might have a phobia relating to animals, swimming, injections, or crowded spaces. They will try to avoid their phobia as much as possible and will experience great distress and difficulty if they have to face it. A phobia will impact a child’s day-to-day functioning and last for more than 6 months.

Social Anxiety (Social Phobia)

Social anxiety is the phobia of social situations or people. Children with social anxiety get overwhelmed by anxiety and stress in social situations. This leads to avoidance, fear or dislike of social gatherings or family get-togethers. At school, children may avoid speaking or attending parties. Teens with social anxiety will feel self-conscious in public settings. 

Sleep Anxiety

Nighttime anxiety in children causes worrying or intrusive thoughts before bedtime. Symptoms include trouble sleeping, seeking reassurance, crying, and procrastinating going to bed. Your child may also argue with you, have anger outbursts, or ignore you near bedtime.

Children with nighttime anxiety tend to be worriers. They may not be aware that they feel anxious, but instead have a feeling that something bad will happen. Whether their fears are real or imagined, they are real to them.  

School Anxiety

Children often feel anxious about school. They may find the lessons difficult or confusing, or dislike their teachers. Some kids avoid school, while others get anxious during big events like exams. They might worry about making friends and fitting in. Some kids might have a genuine cause for their anxiety if they are being bullied. If your child experiences these symptoms often, they will find professional support beneficial. 

Body Dysmorphic Disorder (BDD)

Body Dysmorphic Disorder is when children or teenagers negatively perceive their body and appearance. This perception is extreme and distorted. BDD can affect young people from all genders, although there isn’t much research on this condition in young males. Social media use can sometimes contribute to young people developing BDD.

Health Anxiety

Children and teenagers with health anxiety will worry about their health for a period of 6 months or more. They might frequently check their bodies for signs of illness,  and ask for reassurance that they're not ill. They might try to avoid people or places due to the fear of becoming sick. Health anxiety can be triggered by events, like witnessing a family member become ill or the COVID-19 pandemic.

Obsessive-Compulsive Disorder (OCD)

Children and adolescents with OCD get stuck in a stressful cycle of unwanted and upsetting thoughts that are driven by underlying fear and anxiety. This can lead to them performing recurring or time-consuming rituals such as hand washing, repeatedly checking if doors or windows are locked, or repeating words.

How do you diagnose anxiety in children?

When it comes to diagnosing anxiety in children and teenagers, it's essential to consult with a trained professional who can sensitively and thoroughly assess your child's unique situation. Anxiety can sometimes overlap with other conditions, like depression, ADHD or autism, and even physical illnesses can mimic anxiety-like symptoms. That's why a comprehensive assessment is crucial to rule out any other conditions and focus on your child's specific symptoms.

Our specialists follow the National Institute for Health and Care Excellence (NICE) guidelines when assessing your child. During this process, we also focus on educating you and your child about their symptoms. Early education allows us to clear up any wrong ideas about the condition and talk about symptoms that might not be well-known. This comprehensive and thoughtful approach is designed to ensure that no aspect of your child's well-being is overlooked, leading to an accurate and careful diagnosis.

What causes anxiety in children?

As a parent, it's natural to question whether you could have caused your child's anxiety. However, it's important to know that several factors contribute to anxiety, and it's not your fault. Each child is unique in how they handle stress and challenging situations.

Genetics

Approximately one-quarter of the risk for developing anxiety is due to genetics, according to a large study published by King’s College London. This means that a child's likelihood of experiencing anxiety could be partly inherited from family members. If a parent or close relative has struggled with anxiety, it may increase the child's risk of experiencing similar challenges. However, it's crucial to remember that genetics is just one piece of the puzzle, and other factors like life events and personality traits also play a role in the development of anxiety in children.

Life events

Children can become anxious if they go through overwhelming or traumatic situations. This includes events such as a physical illness, family problems, or bullying. If these stressful events occur in close succession, it may be especially challenging for your child to cope. Sometimes anxiety can occur alongside or be caused by post-traumatic stress disorder (PTSD).

Personality

Some children have a more anxious personality. For instance, traits like shyness or hesitating in new or unfamiliar situations are linked to a higher risk of developing anxiety disorders. Others may pick up anxious tendencies from those around them. 

Hormones

Hormonal changes during puberty can affect a teenager's ability to cope with stress. It's key to remember that even though teenagers might look grown up, their brains are still developing. New responsibilities during adolescence (such as academic pressure or social expectations) can feel overwhelming for many teens, which can trigger anxiety in some cases.

Whatever the cause, we can help your child overcome their anxiety and find the right support.

Can childhood anxiety go away?

Fortunately, young people with anxiety often improve. With the right support, encouragement, and ways to handle stress, many kids get better. 

Cognitive Behavioural Therapy (CBT) is a type of therapy that has been very helpful for children with anxiety. Therapy can teach them how to face their fears, cope with stressors, and manage anxiety better. Sometimes, medicines called Selective serotonin reuptake inhibitors (SSRIs) are used for anxiety, and they are particularly effective when combined with therapy.

The likelihood of anxiety staying around depends on what type of anxiety it is, how old the child was when it started, and how severe it is. Identifying and treating anxiety early can significantly help a child in the long term. 

It's important to know that if anxiety does come back, there are ways to handle it. Sometimes, anxiety might reappear as a different kind of problem, but using the support and skills learned previously can help. We always educate families about the possibility of anxiety coming back and guide them on what to do if you start noticing signs in your child again.

How do you treat children’s anxiety?

We know that every child is unique. That’s why we develop personalised treatment plans tailored to you and your child's specific needs. Our treatment plans are a collaborative process. These plans incorporate your beliefs, values, and the latest clinical evidence. They also follow the National Institute for Health and Care Excellence (NICE) guidelines.

Together, we'll work to identify your child's strengths, difficulties, needs, and coping strategies. Our goal is to ensure that treatment feels manageable and comprehensive. You can rest assured that your child is receiving the best possible care. 

Psychological Education

Our specialists will explain information about your child’s anxiety to help your family work together constructively and manage symptoms more effectively. For example, we might discuss parenting strategies and skills that will help your child.

Talking Therapy

Talking therapies provide a safe space for children to express their feelings and learn coping strategies. For example, some common therapy approaches for anxiety include:

• Cognitive-Behavioural Therapy (CBT): Helps your child understand the link between thoughts and behaviours, breaking negative emotional patterns.
• Dialectical Behaviour Therapy (DBT): Equips your child with strategies to manage intense emotions, build stress resilience, and enhance communication skills.
• Family Therapy: Involves sessions with the entire family to help understand the child's anxiety and how to create a more supportive environment at home.
• Mentalisation-Based Therapy (MBT): Focuses on understanding how thoughts and feelings influence behaviours and acknowledging others' perspectives.

We also understand therapy can be daunting for some, which is why we offer online therapy so you and your child can speak to our experts in the comfort of your own home. Our online therapy services also mean that no matter where you are in the world, we can help you.

Behavioural approaches

We believe in the power of small changes to improve treatment outcomes and provide lifelong skills. We'll integrate these into your child's lifestyle and routine. This might include:

• Motivational Interviewing: Encourages your child to embrace positive change, offering support and practical guidance.
• Mindfulness Techniques: Teaches your child to be present and more aware of their thoughts and feelings.

Diet and lifestyle

Our specialists recognise that it's key to consider healthy sleep patterns, regular physical activity, and a balanced diet to manage anxiety. Ensuring your child gets enough sleep can greatly affect their mood and stress levels. Encouraging them to be active through sports or outdoor play can help release tension and improve their mental well-being. A diet rich in fruits, vegetables, and whole grains provides essential nutrients that can also positively impact your child’s mood. 

Anxiety medication

We understand how difficult decisions around medication can be. This is especially true for young people and their families. Medication can play a beneficial role and we’ll support you to reach the best decision for you. 

We’ll always involve you in the decision process. We will ensure you’re aware of both the benefits and the side effects of medications. Our approach equips you with the latest evidence, research and recommendations for treatment. This helps you make an informed decision about medication or its alternatives. We also provide recommendations about how long your child should take medication, and how to maximise its efficacy.