Dr. Dhillon-Stevens

Anxiety in Children

"Worries Hate Being Talked About…
and once you talk about them they loose their power and often go away."

Adults and children all have worries at some point in their life, it’s natural and understandable, however sometimes worries get out of control and can feel so enormous that they interfere with every day life.

In my practice as a child psychologist and psychotherapist the number of children with worries (anxiety) that interrupt their everyday life has increased and children as young as 3 years of age have attended my clinic.

Anxiety can be very paralyzing and can affect the way we feel, think and act. If this is not managed it can lead to conditions such as panic attacks, phobias, depression, aggression and OCD.

A little bit of anxiety can be useful and necessary, for example in sport, public performance or exams. In these situations the body secrets the hormone Adrenaline as there is mild stress. The body is preparing itself. As human beings when we feel under threat we have various responses, the 5 F’s: fight, flight, freeze, flop or friend. However, if the physical symptoms are not relieved and the threat is persistent anxiety builds up and can lead to a vicious cycle. When this cycle becomes fixated and stuck the child’s anxiety has become out of control and needs professional intervention.

Parents in my experience often notice their child is worried but don’t really know how to approach the subject. Talking about anxiety is not easy. Children often say they cannot find the words or feel no one will understand - that is because anxiety feels abstract - you can’t see it but can feel it. Feelings are difficult to articulate.

Symptoms to look for:

Abdominal pain such as stomach aches
Sudden development of fear - fear of going upstairs on their own, fear of being on their own, especially at nighttime
Feeling faint
Going to the toilet frequently (urination and emptying bowls)
Quick shallow breathing
Rapid heart beat
Feeling irritable
Lack of concentration
Having muscle tension
Nail biting, hair pulling, eyelash pulling

When children are anxious they do not like change - changes in routine, doing new things like going to a club or friends house for tea. Try and be consistent and create structure and order.

Anxiety can be transferred to everyday routines, for example, food - becoming fussy, restricting intake and variation in foods.

Anxious children need a lot of reassurance and attention. Especially at school they want to get things right, dislike making mistakes and spend a long time doing tasks, as they have to be done well and in a precise manner.

Refusing to go to school and creating a high level of distress when the parent leaves the child to say goodbye.

A child who is constantly anxious may develop difficulties with friendships and want to avoid social situations.

Children may worry too much about forthcoming situations or events and create a “what if” scenario.

Experiencing bereavement can cause anxiety, especially existential anxiety and getting in touch with one’s own vulnerability and mortality.

Ultimately, these feelings start affecting how the child feels about themselves and their confidence and self-esteem are affected.

These early signs of anxiety indicate the child is suffering from distress.

So what can help?

Listen to your child’s worries and try and find out the cause of the worries and how they started.

If your child finds it hard to verbalize these I often ask children to think about the feelings inside their body and draw them - once these are externalized we can talk about them through the image. The image provides a platform through which to discuss the worries. As a Child Art Psychotherapist this way of working has always been helpful, especially for young children.

Talk about feelings, create a range of feelings e.g. joy, happy, sad, upset, frustrated, worried, angry and get your child to link their experiences to the feelings. This will help with becoming more emotionally intelligent and in realizing everyone experiences a range of feelings it normalizes sad, upset, worried and angry feelings and thus gives the message these feeling are ok and part of everyday life.

Listen to the negative thoughts and worries and try and reframe these with more positive thoughts. Get your child to practice the positive thoughts.

Never force a child to undertake tasks they feel uncomfortable with, work with encouragement and at their pace.

Structure and order can help children for example instead of suddenly saying it’s bedtime give the child a 15 minute warning. Tell them about the day ahead and who is dropping them off at school, picking them up and any after school activities.

Anxiety can limit children’s potential, creativity and happiness. The key is to take any worries seriously no matter how small or ridiculous they seem to you. If you listen, give your attention and help your child understand that by talking about worries they can be resolved, this will help your child accept that the world is not a frightening place.

Obviously if the condition is not improving, or getting worse, seek professional help.

Dhillon-Stevens, H. (2014) 'Worries Hate…..being talked about'
Published in "Look in Lifestyle" Magazine, Berkshire, October 2014.

Dr. Dhillon-Stevens will be running a live webinar dealing with anxiety in children - this event is aimed at Parents worried about children and young adults. July 8th 2023
Dr Harbrinder Dhillon-Stevens is a BPS Registered Chartered Psychologist, HCPC Registered Counselling Psychologist, UKCP Registered Integrative Psychotherapist (Adults), UKCP Registered Child Psychotherapist and HCPC Registered Child Art Psychotherapist.

Harbrinder has a private practice in Ascot, Berkshire and undertakes training, research, supervision and therapeutic work with children, young people, adults & families. She balances her clinical practice with academic teaching and is an expert witness in working with children and families in assessment and therapeutic treatment.

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