All about anxiety

about anxiety

Everyone feels anxious or worried every now and then.

Some young people can worry about things like starting school or might get anxious when meeting new people. Teenagers may experience anxiety before exams or worry about joining a new sports team. These feelings are natural responses to common situations that are usually short-lived. For some young people, however, anxiety can be severe and persistent, to the extent that it interferes with the activities of day-to-day life and causes problems at school and at home.

Youth anxiety statistics

  • 7% of Australian young people ages 4-17 year old suffer from anxiety disorders1
  • More than 70% of young people experiencing mental disorders don’t access professional support2
  • Most young people feel comfortable using technology to access mental health help3

Having an anxiety condition or disorder can cause prolonged distress and can get worse over time if left undiagnosed and untreated. But the good news is, effective treatments are available.

Anxiety disorders are amongst the most common mental health concerns experienced by young people—at any given time nearly 7% of youths worldwide have an anxiety disorder.4 Anxiety disorders tend to develop slowly over time and start to impact your everyday living. Some common signs in young people include:

  • Wanting things to be perfect.
  • Reluctance to ask for help or ask questions.
  • Difficulty joining in, shyness, or withdrawal from social interactions.
  • Avoidance of fear/anxiety-provoking situations.
  • Difficulty concentrating and/or completing tasks.
  • Seeking reassurance about things that worry them.
  • Feeling ill and/or requesting to go to the sick bay.
  • Fear of exams, presentations, or performance-based situations.
  • Worrying that performance on assignments, exams or presentations will not be good enough.
1 (Lawrence, 2015)   2 (Vogl G., 2016)   3 (Vogl G., 2016)   4 (Polanczyk GV)

How digital CBT works

Cognitive Behaviour Therapy (or CBT for short) is a type of talk therapy that can help people of all ages, including younger children and teens. CBT focuses on how thoughts and feelings affect our bodies and our behaviour. You don’t need to have a diagnosed mental health condition to benefit from CBT.

This approach is designed to help you recognise unhelpful thoughts and behaviours and learn how to change them; it focuses on the present and the future, rather than on the past. CBT can help you understand the negativity of your thought patterns and learn how to replace those thoughts with more positive ones, giving you realistic strategies to improve your life in the here and now. Once you have developed new thinking habits, your new skills will help you navigate challenges throughout your life.

CBT works by targeting the physiological (e.g., stomach aches, nausea, elevated heart rate), behavioural (e.g., avoidance, tantrums, irritability) and cognitive (e.g., faulty thoughts) components of anxiety.

Physiological arousal associated with anxiety is targeted through behavioural techniques such as relaxation strategies and breathing retraining, whereas cognitive aspects are addressed using cognitive restructuring, positive self-talk, and coping statements.

The cognitive component specifically aims to help young people identify faulty thoughts & beliefs and challenge them and to teach new skills or replace them with more helpful thinking styles. 

Finally, the behavioural component, or avoidance of anxiety-provoking situations, is managed with behavioural techniques, by exposing the young person to feared situations as well as teaching problem solving to encourage consideration of alternative behavioural responses to anxiety-provoking situations.

Additional CBT techniques employed in anxiety interventions include contingency management strategies and parent management training. Such techniques form the basis of anxiety interventions and have been extensively researched in both child and adult populations.

Ultimately, CBT interventions do not necessarily aim to completely eradicate anxiety, but rather provide children and parents with the skills to better manage their fears and worries. Thus, childhood anxiety interventions also aim to provide the child and parent with enough skills to potentially prevent the development of further anxiety disorders in adolescence or adulthood.

Anxiety disorders

For a young person with an anxiety disorder, the anxiety does not go away and can get worse over time. The symptoms can interfere with daily activities such as school work and relationships.

There are different types of anxiety. The most common are:

Separation anxiety disorder
Separation Anxiety Disorder is characterised by excessive worry about separation from home or from major attachment figures that is beyond the normal limits for the child’s developmental age. The underlying concern for the child is a fear of something harmful happening to themselves, or their caregiver5. Children with separation anxiety often become tearful, display temper tantrums or complain of somatic complaints (e.g., stomach ache, nausea etc.), in anticipation of, or in the event of separation from caregivers.

5 (American Psychiatric Association, 2013)

Generalised anxiety disorder
Generalised Anxiety Disorder is defined by continued excessive or unrealistic anxiety or worry (apprehensive expectation) about events or activities6. Children with a generalised anxiety disorder are often described as “worriers”. Moreover, they have difficulty controlling their worry and often seek reassurance or comfort from others (e.g., by asking “what if?” questions or checking if something is correct). Common worries in children with generalised anxiety disorder typically include schoolwork, not being good enough in sports or other activities, family, friends, health, new situations, and world events. These worries are often accompanied by symptoms of restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbance.

6 (American Psychiatric Association, 2013)

Social anxiety disorder (Social phobia)

Children with Social Anxiety Disorder are fearful of social or performance-based situations in which they are exposed to unfamiliar people or the possible scrutiny of others (APA, 2013). They fear they will act in a way that is embarrassing and will be criticised by others. In the classroom this can present as a fear of talking in front of the class, taking part in music or athletic performances, and playing with other children. When faced with these situations, children with social anxiety often cry, get angry, freeze up, withdraw, hide behind people, or try to avoid the situation altogether. The distress and avoidance of social situations may lead children with social phobia to have poorer social skills, fewer friends and be less involved in extracurricular activities.

Specific phobia

Specific Phobia is defined by a significant and persistent fear of a particular object or situation. Common phobias in children include fear of the dark, thunderstorms, animals, insects, heights, needles, and other medical procedures (APA, 2013).  When confronted with the feared situation or object, phobic children will become extremely anxious and distressed and will try to avoid the object or situation wherever possible. Phobias in children are distinguished from normal childhood fears by the marked degree of anxiety and avoidance, which is excessive compared to other children of the same age, and which interferes with family, social, or school functioning.

Obsessive-compulsive disorder

Obsessive-Compulsive Disorder (OCD) is characterised by the presence of intrusive, recurrent thoughts, images, or impulses (known as obsessions), which are usually alleviated or neutralised by repetitive behaviours (known as compulsions). Common obsessions reported by children and adolescents include concerns about harming others or themselves, contamination, superstitious ideas, and religion. Common types of compulsions include washing, checking, touching, ordering, and hoarding. OCD is a debilitating condition that has a significant impact on family and peer relationships, causes marked distress, is time-consuming and significantly interferes with daily functioning in addition to school performance (APA, 2013).

Panic disorder

The essential feature of Panic Disorder is frequent and unexpected panic attacks and subsequent worry about future attacks. A panic attack is defined by a sudden onset of intense fear or discomfort that reaches a peak within minutes. Symptoms experienced can include heart palpitations, sweating, trembling, dizziness, breathlessness, nausea and paraesthesia (“pins and needles”), and these symptoms are typically misinterpreted as something being wrong, perpetuating the panic cycle (APA, 2013).

Post-traumatic stress disorder

Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder that develops following exposure to a traumatic, physically threatening event and is characterised by a persistent re-experiencing of the trauma (APA, 2013). Traumatic events may include natural disasters (e.g. fires, floods, cyclones), severe car accidents, witnessing someone else die or be badly injured, sexual abuse, robbery, or physical abuse. Children with PTSD may re-experience the trauma in several ways, such as repetitive play, nightmares, distressing recollections and severe anxiety when exposed to cues that remind them of the traumatic event. They may also try to avoid situations or objects that are associated with the traumatic event. 


A secondary disorder to panic disorder and is defined by anxiety or avoidance of places in which panic may occur. Situations that young people commonly avoid for fear of having a panic attack include classrooms, public transport, cinemas, crowded environments, and being outside the home. Panic disorder is extremely rare in children and is not commonly seen until late adolescence.

The information in this document is general advice only. The advice within it may therefore not apply to your circumstances and is not intended to replace the advice of a healthcare professional.

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