Anxiety

When a child is gripped by worry they cannot switch off, or starts avoiding the things they used to manage, it's difficult to watch and easy to feel helpless. Anxiety is the most common reason children are referred for mental health support in England^[1], so if this is your family, you're in very large company. This guide is here to help you understand what is actually happening, tell the normal worry from the kind that needs help, and know what genuinely makes a difference.

If your child is in immediate danger, or you believe they may act on suicidal thoughts, do not wait. Call 999 or go to A&E. If they are having suicidal thoughts but are not in immediate danger, or you're worried, contact your GP and ask for an urgent appointment, or call NHS 111 and choose the mental health option. You can also reach the Samaritans on 116 123, Childline on 0800 1111 (for under-19s), or text SHOUT to 85258. Finding Therapy is not a crisis or emergency service.

What is anxiety, and when does it become a problem?

Anxiety is a normal human response to perceived threat. One helpful way to understand it is through the body's stress response: when something is perceived as threatening, the heart speeds up, breathing becomes shallow, muscles tense, and digestion slows down. In a real emergency this is a brilliant system. It's what gets a child out of the way of a car they didn't see coming.

The trouble starts when the brain begins firing that response for things that aren't actually dangerous: a maths test, a friend not replying to a message, a noisy assembly hall. The body can react as though the threat were real, even when it isn't. For many children, occasional anxiety is healthy and passes. When the response becomes persistent, out of proportion to the trigger, or starts interfering with daily life, those are signs that the anxiety may need assessment or extra support.

So instead of asking "is my child anxious?", it can help to ask "how much is the anxiety getting in the way of their life?" That is often what separates a feeling every child has from a difficulty that deserves support.

How common is anxiety in young people, and why is it rising?

It's common, and it's been climbing. The clearest UK picture comes from the NHS survey of children's mental health in England, which found that around 1 in 5 (20.3%) of 8 to 16 year olds had a probable mental disorder in 2023 ^[2]. That is up from around 1 in 8 (12.5%) in 2017, with the steepest climb around 2020 before the rate levelled off. When the survey last looked at specific conditions in detail, in 2017, anxiety disorders were the most common^[3].

It doesn't stop at the teenage years. Rates stay just as high into early adulthood: 23.3% of 17 to 19 year olds and 21.7% of 20 to 25 year olds had a probable mental disorder in 2023 ^[2]. From around age 17, rates are also roughly twice as high in young women as in young men. If you have a teenager heading towards exams, university or a first job, these are the ages at which the 2023 survey found rates were highest.

Why the rise? It's not a single-cause story. Factors that have been suggested include the disruption of the COVID-19 pandemic to schooling and friendships, the comparison and high-stimulus pull of smartphones and social media, a high-stakes assessment culture in UK schools, less unstructured time outdoors and with peers, and a growing willingness to name anxiety, which means more of it may be recognised rather than dismissed. The evidence for each varies, and some of the rise may reflect better recognition as well as a genuine increase.

The many types of anxiety in children and young people

The word "anxiety" covers several different types, and the difference matters because effective help is matched to what is actually going on. These are brief descriptions to help you recognise them, not a way to diagnose them: only a qualified professional can make a diagnosis, after a proper assessment. A child with significant anxiety may have one or more of the following.

• Generalised anxiety disorder (GAD). Persistent, free-floating worry that is not attached to one trigger. A child with GAD may worry about everything from family health to a school trip three months away.
• Social anxiety. An intense fear of being judged, embarrassed or rejected. It can look like avoiding parties, refusing to speak in class, or going silent in unfamiliar groups, and it often begins in childhood or the early teenage years. Our guide to social anxiety covers it in depth ^[4].
• Separation anxiety. Difficulty being apart from a parent or carer, common in younger children but able to resurface in teenagers after illness, bereavement or change.
• Specific phobias. An intense, often out-of-proportion fear of a particular thing: dogs, vomiting, needles, the dark. Phobias are easy to overlook because they're situational, but they can quietly narrow a child's world, and our guide to phobias covers them in detail.
• Panic disorder. Sudden, intense surges of fear with strong physical symptoms, a racing heart, dizziness, a sense of doom, that can feel like a medical emergency to the young person having one. Our guide to panic attacks covers this in depth.
• Health anxiety. Intense worry about illness or death, often with repeated reassurance-seeking and frequent symptom checking.
• Selective mutism. An anxiety condition where a child can speak freely at home but is consistently unable to speak in certain settings such as school. It usually starts between the ages of 2 and 4, and affects around 1 in 140 young children ^[5].
• Exam and performance anxiety. Common around GCSEs, A-Levels and other high-stakes assessments, and sometimes the reason a teenager first comes for support. It can also be part of why a young person starts avoiding school altogether, which our guide to emotionally based school avoidance covers.

One close cousin sits slightly apart. Obsessive-compulsive disorder (OCD), a pattern of intrusive thoughts and the repetitive behaviours done to neutralise them, used to be grouped with the anxiety disorders but is now classified separately ^[6]. Anxiety is often part of the picture, and OCD can occur alongside anxiety disorders, so it's worth knowing about, but it's treated as its own thing, and our guide to OCD covers it properly.

Many young people present with more than one of these at once. Social anxiety and generalised worry frequently travel together. The aim is not to diagnose your child at home, but to recognise that "anxiety" can mean several different things, and that the right help has to fit the particular pattern.

How anxiety shows up at different ages

Anxiety looks different as children grow.

Under sevens tend to express anxiety through the body and through behaviour rather than words: stomach aches, headaches, clinginess, a return to earlier habits, and meltdowns at separation points such as drop-off and bedtime. Younger children often can't yet name the feeling as anxiety.

Primary-age children start to find the words but often default to physical complaints, refusing specific activities, or perfectionism. You may see catastrophic thinking emerge ("what if you don't come back?") and a lot of reassurance-seeking.

Teenagers experience anxiety in a way that looks closer to the adult version, but with hormones and identity layered on top. The signs can include withdrawal from friends, dropping activities they used to love, disrupted sleep, irritability, self-criticism, and avoiding particular situations. Many teenagers also mask anxiety in public and let it out at home, which can look to parents like a wildly inconsistent child.

Young adults (17 and over) may feel anxiety around exams, leaving home, relationships and identity, sometimes tangled up with perfectionism. The 2023 survey found rates of probable mental disorder were highest in this age group, and anxiety can get in the way of university or an early career.

Every child is different, so these are common patterns rather than a checklist. A child can be anxious without showing any of them, or show some without being anxious. If you're worried, ask them how they're feeling and talk to your GP.

Anxiety in neurodivergent children

Anxiety is significantly more common in children who are autistic or have ADHD. Around 40% of autistic children and teenagers are estimated to have at least one anxiety disorder, far above the general-population rate ^[7], and nearly 1 in 5 children with ADHD have an anxiety disorder too ^[8].

For many of these children, the everyday school environment can be genuinely overwhelming in ways that are not visible to others: fluorescent lighting, unpredictable social dynamics, sensory input they cannot filter out, constant transitions. A child carrying those demands all day can run out of internal resources by mid-afternoon. Where prolonged masking and unmet needs build up, the result can be autistic burnout, a state of deep physical and emotional exhaustion described in research with autistic adults ^[9].

For neurodivergent young people, anxiety is not always best understood as a separate condition to be treated. For many, it is linked to a poor fit with their environment and to unmet needs, not to being autistic or having ADHD itself. What helps often includes a combination of adjustments to the environment, such as predictable routines, sensory accommodations and a safe person at school, alongside therapy that is neurodivergence-affirming. Neurodivergent young people can also have an anxiety disorder in its own right, though, so if anxiety is persistent or severe, it's worth getting it properly assessed.

What it’s like for parents

Living alongside an anxious child can be exhausting. You may feel constantly on alert, adjusting plans to avoid setting them off, walking on eggshells through bedtimes, mornings or specific times of the week. Plans become provisional. You may find yourself quietly rearranging your life around what your child can and cannot cope with that day.

Many parents also feel guilt and self-doubt, to ask "am I doing enough?" or "am I making it worse?" Those are valid questions when it comes to helping them. The next section covers what the research actually says about a parent’s role.

The parent's role: what the evidence actually says

Here’s something important to know, and it's good news. How a family responds to a child's anxiety can make a real difference to recovery. A large review of 47 studies found that parenting style explains only about 4% of the differences in how anxious children are ^[10]. Much of the rest comes from other things, including temperament, inherited vulnerability and life experiences.

What you do still matters, though, and in a specific way. Many parents of anxious children end up accommodating the anxiety: giving repeated reassurance, helping them avoid the things they fear, stepping in to answer for them ^[11]. It's the most natural thing in the world, because it soothes the distress in the moment. The difficulty is that heavy accommodation can bring short-term relief that reinforces avoidance, which research has linked with more anxiety over time.

The encouraging flip side is that changing how the family responds can really help, to the point where it can work even when the child is not the one in the therapy room. In a UK trial with children aged 7 to 12, coaching parents to deliver the therapy themselves recovered half the children from their main anxiety disorder, compared with a quarter on a waiting list ^[12]. A separate US programme that works only with parents was found to work about as well as standard child therapy ^[13].

In other words, how a family responds is something you can influence, and it can be an important part of helping anxiety ease.

What you can do as a parent

Several practical things can help at home, though every child is different, so it's about finding what works for yours.

• Validate the feeling, not the fear. When your child says "I can't go to school," the instinct is to argue. It often helps more to acknowledge the fear first: "I can see you really don't feel able to face it today. Let's work out what's going on." Feeling understood often helps a child calm down, while arguing tends to raise the stress.
• Co-regulate before correcting. When a child is very stressed, they may find it much harder to take in logic, consequences or rewards. If your child is in acute anxiety, talking slowly and calmly, slowing your own breathing, and not adding extra demands usually helps more than explaining why the fear is not rational.
• Be careful with reassurance. Repeated reassurance comforts in the moment but can quietly feed the cycle, especially when the worry keeps coming back in a new form. Try acknowledging the feeling rather than answering the same question for the fifteenth time.
• Resist over-accommodation. It's tempting to shield a child from everything that triggers anxiety, but the short-term relief of avoiding things can reinforce avoidance and keep the fear going. First, make sure the situation is genuinely safe and try to understand what is driving the avoidance. If it's school your child is avoiding, work with the school to find out what is making it hard to go, because things like bullying or unmet needs can be part of the picture. Where it's right to build back up, small steps, planned carefully and never forced, often help the anxiety lift, and a counsellor can help you plan them.
• Look after yourself. Children often pick up on the emotional state around them, so your own steadiness can really help, and that is easier when you are getting enough rest and support yourself.

When to seek professional help

Occasional anxiety is part of childhood. When you're deciding whether to seek professional help, it can help to think about three things, which we call the "3 Ds":

• Duration. The pattern has lasted a while, or keeps coming back. You don’t have to wait for any set length of time if you’re worried.
• Distress. Your child is finding it very hard to cope.
• Disruption. It’s getting in the way of school, friendships, sleep, eating or family life.

If you recognise any of these, or you're worried for any other reason, it's worth a conversation with your GP. These are prompts, not a checklist: a child can be struggling without fitting them neatly. It helps to prepare for that conversation, noting recent examples and how the anxiety is affecting daily life, so you get the most from the appointment.

It helps to go in with clear eyes about the NHS picture, though. In 2024-25, more than 365,000 children in England were still waiting for their mental health treatment to begin at the end of the year, and more than a third of those had already been waiting over a year, with one in six waiting more than two years ^[1].

Waiting times vary by area, and some families choose to combine the NHS route with private counselling so their child has support while they wait.

How counselling helps with anxiety

There is good evidence that therapy can help anxious young people. A large Cochrane review, pooling 87 trials with nearly 6,000 children, found that around half no longer met the criteria for their main anxiety disorder after a course of CBT, compared with fewer than 1 in 5 left on a waiting list ^[14].

No single method is right for every child. Cognitive behavioural therapy (CBT) is the most-tested (it is the therapy those trials looked at) and a common starting point: it helps a young person understand the anxiety cycle and gradually face the things they have been avoiding. It's one strong option among several, and many counsellors integrate it with person-centred and relational therapy, which builds confidence through a trusting relationship. Alongside these, creative or play-based approaches often suit younger children. Across different types of therapy, the strength of the relationship between a young person and their counsellor is consistently associated with better outcomes ^[15].

Counselling is what Finding Therapy offers, and it does not replace your GP or NHS mental health services. If your child needs a specialist assessment, those routes still matter. Counselling can support many young people with anxiety. Where a child has a diagnosed anxiety disorder, a specific evidence-based treatment, most often CBT, may be recommended, so it's worth asking any counsellor about their training and approach.

A clinical perspective from one of our counsellors

Edi Fratczak, MBACP, a Finding Therapy counsellor with experience in anxiety in children and young people, shares how she works in her sessions:

"I've spent the past five years supporting children and young people with anxiety in both schools and online settings, working with social anxiety, exam stress, separation anxiety, school refusal, panic attacks, and anxiety linked to trauma or change. My first priority is to create a safe, calm, and non-judgemental space where young people feel heard and understood. From there, we use a mix of creative and practical tools: worry jars, emotion cards, body maps, coping wheels, breathing exercises, grounding techniques. We explore what triggers their anxiety, what the early warning signs look like, and what specifically works for them to feel more in control. Together, we build a toolkit they can use in everyday life."

"Online therapy can suit many anxious young people. Many find comfort in being in their own familiar space while accessing support, which can make it easier to engage. The Finding Therapy platform offers tailored canvases designed around common anxiety challenges, covering themes like social anxiety, reframing anxiety, dissociation, and panic attacks. These give young people a hands-on, interactive way to engage with their anxiety rather than feeling pressured to talk about it directly. They also empower the young person to take an active role in their own care, building insight and coping skills at their own pace."

"Improvements tend to happen gradually, and every young person's pace is different. Many young people begin to notice better sleep, improved eating habits, fewer emotional outbursts, or start to face situations they used to avoid. Anxiety can feel overwhelming, but it doesn't have to control someone's life. With understanding, support, and practical tools, confidence grows one small step at a time."

Why online therapy can suit anxious young people

For many anxious young people, walking into an unfamiliar therapist's office is itself anxiety-provoking enough to delay or derail therapy. Online therapy can make that first step easier. For anxiety and depression in children and young people, research suggests therapy delivered through a screen can work about as well as meeting in person ^[16], a finding echoed in other reviews of therapy for young people ^[17]. NICE has conditionally recommended four guided self-help digital CBT programmes for children and young people with mild to moderate anxiety or low mood, used with regular support from a professional while more evidence is gathered ^[18]. These are structured digital programmes, which are different from live sessions with a counsellor.

There's an important caveat: research suggests online therapy can work about as well as in person when there's a real therapist guiding it, which isn't the same as a child working through an app alone. For many young people, working with a skilled therapist over video from their own bedroom has been found to produce outcomes comparable to in-person work, and with no journey to make, it can be easier to keep coming. Online counselling isn't right for every situation: where there is a significant risk to safety, a safeguarding concern, or a need for more intensive or specialist assessment, other support may be better.

Recovery is realistic

The word "recovery" can mislead with anxiety. It doesn't mean a young person never feels anxious again, because anxiety is a normal emotion they'll feel throughout life. Recovery may involve the anxiety becoming more manageable: understanding what is happening in their body, having tools to respond, and no longer feeling controlled by it. Progress looks different for every child, and ups and downs along the way are common.

The long view is encouraging. UK research that followed thousands of children into adulthood found that those whose emotional difficulties eased over time were not at raised risk of poor adult outcomes, unlike those whose difficulties persisted ^[19]. This suggests that when a child's emotional difficulties ease, the longer-term picture can look much brighter too. That's one good reason to get support early rather than waiting to see if they grow out of it.

A final word

If your child is struggling with anxiety, it can help to remember two things: anxiety often responds well to support, and getting the right help early can make a real difference to how things turn out. Anxiety has many roots, and what helps depends on what is feeding it. With the right support at home and a counsellor who fits them, anxiety patterns can change.

At Finding Therapy, our counsellors are experienced in working with anxiety across a wide range of ages and needs, from younger children with separation anxiety to young adults navigating panic and social anxiety. You can look through the counselling directory and choose a counsellor who feels like the right fit, or, if you'd like a recommendation, book a free consultation and you'll speak to our Head of Counselling. There's currently no waiting list for our counselling. Some children also need a specialist assessment or treatment, which your GP can help arrange.