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Anxiety (worry)

What is anxiety?

Anxiety is a word we use to describe feelings of worry, fear and panic. As well as these emotional feelings, people with anxiety might also experience physical (body) sensations such as a racing heart, breathing fast, sweaty hands, dry mouth and feeling shaky. Many people also have “what if” or negative thoughts when they are anxious.

Anxiety is a normal human response to feeling threatened or in danger, even if that threat or danger is a thought, image or memory. Anxiety can become a real problem if these feelings are very strong, happen even when there is no real danger or if it lasts for a long time. Lots of people experience worry and anxiety although for some people it can impact on everyday life and get in the way of school/college, socialising and even home life.

Common types of anxiety include:

  • Worries about what other people think of you or worries about being judged negatively and not feeling good enough
  • Worries about bad things happening to you or the people you love and care about
  • Uncontrollable constant worry about lots of things (like school, the future, health, world events)
  • Worries about your safety and health (including worries about germs and contamination)
  • Phobias (big fears) about specific things
  • Worries that you are responsible for bad things happening
  • Feeling the need to complete certain routines, rituals or behaviour to stop bad things from happening (commonly known as Obsessive Compulsive Disorder)

What to do about anxiety?

Take the first step - if you think you are affected by anxiety, contact your GP or talk to your school/college nurse or an adult that you trust.

If your health professional thinks you are suffering from anxiety, they will probably suggest a treatment plan for you to follow. They should catch up with you regularly to see how you're getting on.

  1. Worries and anxiety are common; everyone worries so it’s important to remember you are not alone. Some worries may seem very real and very scary. Tell someone how you are feeling no matter what your worries are, even if you are worried about doing so. There will be someone who will listen and try to support you.
  2. Although anxiety feels horrible, remember these feelings will pass and the physical sensations cannot harm you. Remind yourself that you have been anxious before, that those feelings passed, that you coped and were ok. If you need to, use activities, such as watching TV, spending time with friends, reading, making things and listening to music, to help manage until you feel a bit better.
  3. You cannot avoid all the things that make you feel anxious so face your FEARs with confidence following these four steps; you can find lots of these on the YoungMinds website.
    • Focus – rather than worry about the past, future or the unknown, focus on the present moment, the here and now
    • Expose – the more you face your fears the easier it will become to manage
    • Approach – the fear of experiencing anxiety is often worse than the situation you are avoiding. Face your fear and see for yourself that the situation probably isn’t as bad as you are predicting
    • Rehearse – practise anxiety management techniques.

Contact services

BeeU - A partnership of different services offering support and advice to children, young people, and families, in Shropshire and Telford & Wrekin. This partnership is made up of Healios, Kooth and CAMHS.

  • Healios - A leading digital provider of mental health, autism, and ADHD services for children and young people aged 25 and under.
  • Kooth - Provides an anonymous 24-hour online service, 365 days per year, offering peer support, self-help and trained and qualified counsellors available to talk to online.

There are many sensory issues associated with sleep including:

  • Sensitivity to sound, touch, and visual stimuli which can be distracting and distressing and can affect the process of falling asleep.
  • Interoception difficulties, particularly recognising when hungry, full or thirsty or when the person is tired. 
  • Some children are more sensitive to foods like sugar, caffeine and additives which keep people awake.

Look at the bedroom environment to see what may be affecting their ability to go to sleep and stay asleep. Do their pyjamas and bedclothes feel comfortable, are they too hot or cold?  Is it too light or too dark, too noisy or too quiet? Perhaps it is too cluttered and stimulating. Think about your child’s diet. Are they eating too early or not having enough to eat? Are they eating food that can stimulate them close to bedtime. There can be added difficulties where children have restrictive diets but some simple adjustments of what is eaten and when can make a big difference. 

Click here for more information on sensory issues.
 

Sticking to the same routine helps your child to know what to expect at bedtime and helps them feel secure. It also helps to support your child’s internal body clock and keep it on track. The age related sleep advice and information on this website can help with establishing routines. Some children will benefit from using picture timetables, timers or social stories to help them understand their bed-time routine. More information about visual supports can be found on these websites

Visual Resources | Autism West Midlands 
Visual Supports | Autism Toolbox Autism Toolbox

Your child may be feeling overstimulated after a busy day and needs help to wind down, or their environment may be overstimulating with lots of toys, TVs and computers within reach. Avoiding TV and computers or hand-held devices an hour before bedtime can help your child to wind down. Activities that are good for the wind down period are jigsaws and colouring. Having a relaxing bath and milky drink can help some children, but for some children having a bath can over-excite them so they may need to have their bath earlier in the day.

Children who wake to use the toilet, wet the bed, or who wear nappies or pull-ups at night that need changing may have disturbed sleep. Eric, the children’s bowel and bladder charity are a good source of advice on this topic.

 

What might help 

Keeping a sleep diary 

A sleep diary can help you understand what may be causing difficulties with sleep. Fill it out every evening and record as much as you can. You can use it to spot patterns and make changes that may help. 

The Sleep Charity have templates you can download; one for teenagers and one for younger children. 

Seeking advice and help from sleep services 

There are organisations that can help you if you are having difficulties with your child’s sleep. There are many national organisations, including those who specialise in sleep for SEND families, and there are also community-based services in Shropshire, Telford and Wrekin. Click the link at the bottom of page to visit our support services page. 

Understanding sleep cycles 

The circadian sleep cycle is a 24-hour cycle that helps govern essential bodily functions especially the sleep-wake cycle. It plays a vital role in a person’s ability to sleep in one consolidated block of time at night and to stay awake during the day. As the sun sets in the evening, the brain begins producing melatonin, a hormone that induces sleepiness. Core body temperature also drops.

As melatonin and tryptophan (an amino acid which helps produce melatonin) are naturally produced in the body, there are things you can do to help their production.  Darkness helps to promote the production of melatonin which is why it is a good idea to put your child to sleep in a darkened room, and light emitting devices such as tablets and phones also can destroy melatonin so should not be used for at least an hour before bed. New research shows that limiting exposure to screens and increasing physical activity levels during the day has a positive effect on children's overall physical, mental health and wellbeing, including sleep.

Setting a waking time consistently even in holiday times, which is called ‘anchoring’ the wake time, can help to reset the body clock over time. This should be accompanied with exposure to lots of light on waking to support circadian rhythm. 

Melatonin and tryptophan occur naturally in some foods and drinks such as milky drinks and cereals which is why having a milky drink before bed can help settling to sleep. For more information visit Diet & Sleep - The Sleep Charity

Prescriptions of melatonin

Behavioural strategies and practical solutions are the best way to address sleep difficulties, but if they are having a significant impact on your child’s ability to function, a drug form of melatonin is sometimes prescribed for neurodivergent children. As the drug’s function is to re-set sleep and wake cycles, it works best combined with good sleep hygiene practices. It is important that is it taken under medical supervision and not purchased on-line so that it is closely monitored for dosage and side effects. It should be prescribed for the shortest period necessary as the long-term effects of the drug on children’s development are not yet known.

 In Shropshire, Telford and Wrekin the Community Paediatric Service and the CAMHS (BeeU) Service) can prescribe melatonin for children and young people who meet ALL of the following criteria.

  1. the child/young person must be open to and being treated by the service due to a neurodevelopmental/mental health need (diagnosis is not required but the child must be being seen by the service, not on a waiitng list)
  2. sleep issues are causing significant impact on the child/ young person, for example due to daytime sleeping or behavioural problems that are impacting daily functioning or educational attendance
  3. behavioural approaches have been tried and failed. These may have been offered by the service (where available) or by community sleep support services.

GPs are unable to prescribe melatonin although they sometimes issue repeat prescriptions when prescribing has been started by a specialist (such as a paediatrician or child psychiatrist). 

Further support 

Click on the link below to visit a page with information about

  • national websites and sleep organisations
  • local community services in Shropshire, Telford and Wrekin.