Anxiety has been named as children’s ‘word of the year’ in 2021, according to research by Oxford University Press.

So for Children’s Mental Health Week 2022, we asked Angela McMillan of Elemental Health, an organisation that specialises in helping young people to overcome anxiety, if she had any tips for talking about anxiety with your teenager.

She went one further and gave us some expert advice on spotting the signs, having the actual conversation and finding places to go for help.

Here’s what she wrote:

Angela McMillan of Elemental Health Ltd

Help! I don’t know what to do!

It can feel scary thinking that your teenager might be experiencing anxious thoughts, worries and fears. 

As we head into Children’s Mental Health week there are lots of stats that show mental health problems are on the increase and it can be hard to know where to look to get information and support that really works.

As a counsellor of young people here are some of the signs for you to look out for and my favourite strategies for starting a mental health conversation. 

First things first, what is anxiety?

The first thing to say is anxiety is a normal part of being a person, but if it starts to affect how your teenager is living their life then that’s a good time to check in.

My favourite definition of anxiety is:

‘An overestimation of danger and an underestimation of resources’ (@NICABM)

It is a response based on prediction which can result in a Fight, Flight, Freeze or Flop response.

Things to look out for

  • Physical symptoms like aches and pains, stomach trouble, headaches, complaints of heart racing or sweating and panic attacks.
  • Avoiding people or places or certain situations, becoming focused on something being ‘wrong’ with them physically and repeatedly checking the web for evidence of health issues or concerns. It might also change their eating and sleeping patterns.
  • It can cause mind blanks, feeling embarrassed, not wanting to speak up in public or wanting to avoid spending time with loved ones. They might also feel scared about certain things

Lesser known

There are also some lesser known signs that you can look out for too:

  • Overworking, perfectionism, fear of making mistakes, procrastination or avoiding situations they used to enjoy
  • Being the joker, needing to be in control, wanting constant reassurance or asking lots of questions.
  • Angry outbursts, emotional upset, an inability to make decisions
  • At its extreme end it can cause emotional shut down and result in things like excessive scrolling, gaming or use of drugs and alcohol

Remember that you know your child best, if something feels ‘off’ or if their behaviour has changed then that’s a great time to check in.

Teenagers are more likely to be spending time with friends and opening up to them more frequently than they are to you – not only is that normal, it’s a healthy part of them growing, if you’re noticing changes in their friendships or how they relate to others then this can sometimes be a sign that something is going on.

What you can do

It sounds obvious, but picking a time when you both feel calm often works better than when they are experiencing overwhelm. This might be in the car on a drive, going for a walk together or watching tv. Activities that don’t involve eye contact can take the pressure off and avoiding situations that are stress points can really help too.  

Saying things like ‘I have noticed’ helps them feel seen. ‘I have noticed you’ve not wanted to go to the gym for the last few weeks’ or ‘I have noticed you are not spending time with your friends so much’ can open up conversations.

Wondering aloud is another favourite of mine ‘ I wonder if this is because of (insert your thoughts).’ This gives them the chance to say ‘yes’ or to say ‘no’ and to open things up. I also use TV shows, books, movies (whatever their passion is) as a way in – especially if a character is having a hard time.

Let them know you feel worried and that you want to find ways to help.

Anxiety likes to know what’s going on, so simple things like:

  • Visual timetables
  • Shared calendars 
  • Open conversations about what might be happening across the week can really help

This might seem very similar to the kinds of things you did with them as a little child because in times of stress we can regress and meet them in that emotional space.

It’s ok if they don’t agree with you or won’t open up to you during the first conversation, or if they tell you everything is fine when you know it probably isn’t. You know that tricky conversations can sometimes cause shut down. Keep going and keep checking in and if it feels overwhelming for you then please get support for yourself too. I love Young Minds Parentline or Gingerbread.

Some ideas

Encouraging helpseeking behaviour is a big step and I always recommend to clients that they visit the GP for some simple blood tests and a check up to rule anything out. Some vitamin deficiencies can cause symptoms similar to mental health issues and it’s helpful to get checked out. If they are worried about going to a GP there is a great site called Doc Ready that can help them prepare.

Anxiety LOVES to avoid things, but avoiding things won’t make it go away, creating plans together to help them face the fear can really help. 

It can be horrible seeing your child really worried or upset, and it’s natural to want to take this pain away from them – most of us are guilty of giving into the fears or supporting the avoiding behaviour but we also know long term this doesn’t always help. The anxiety just pops up again in a slightly different way. How can you help them take small steps to face their fear?

Simple breathing strategies like the physiological sigh (two long inhales through the nose and one long exhale) is one of the easiest ways to reduce in the moment stress according to neuroscientist Dr Andrew Huberman and some people find mindfulness or mindful breathing can help.

Anxiety likes to move and if your child is experiencing a flight response where they need to run around then planning with them about how they can do this safely can make a difference. 

Helping them find ways to move before the anxiety hits can also really help. Walk, run, dance – whatever works for them.

If they are more prone to a fight response then jumping up and down can release tension and one of my favourite anger busters is chewing on something crunchy like a carrot stick!

If you are waiting for a referral don’t forget that Childline are an amazing resource and also offer counselling via email or instant messenger 24/7 whilst they are waiting for other services.

Ange McMillan is a British Association for Counselling and Psychotherapy accredited counsellor, NLP coach and Thrive Childhood years practitioner. She delivers mental health awareness training across the world and runs a parent group to support parents with children experiencing mental health issues. 

She has a particular interest in helping young people overcome anxiety.

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