Just like with adults, it's totally normal for children and young people to feel anxious sometimes, but it becomes a problem when it overwhelms or gets in the way of normal living.
Children and young people have a lot to feel anxious about:
Change from a cosy little primary school to a scary, huge secondary
Bodily changes - is this normal? Am I the same as everyone else?
Academic challenges - SATs, 11+ test, GCSE choices and exams
Hormone changes causing fluctuating emotions
High expectations in school, home and social lives
Pressure from social media
Need to fit in with friends and rebel, while also craving parental approval
Peer pressure
Drug or alcohol use (often linked to peer pressure)
Anxiety can be scary for anyone experiencing it for the first time so understanding it is a vital part of learning to cope with it.
When I first talk to children of all ages about anxiety and mental health, they express relief that what they are feeling is both normal and something they can learn to deal with themselves.
Anxiety about anxiety is very real and understanding your anxiety and feeling you have some control over it can make a massive difference.
The main parts of the brain we need to think about are:
The Amygdala
The Brainstem
The Hippocampus
The Prefrontal Cortex (PFC)
Below I will talk about each of these areas. We'll start with 'The science bit' which is a basic understanding of each area. This is useful for adults or older teens. I will then say how I would explain this to children aged 10+
The Amygdala
The science bit:
The amygdala is part of the limbic system which is a group of structures linked to processing emotion. The amygdala is linked to processing fear and the detection of threats. It is a simple structure and therefore works very quickly to respond quickly to, say, an attacking bear. When the amygdala becomes aware of a threat (either a physical one or an internal one such as a worry) it initiates the fight or flight response to ready your body to either attack the bear (fight) or run from it (flight) in order to keep you safe.
Older child and teen explanation:
The amygdala is a lot like a smoke alarm. Smoke alarms are designed to warn you that you are in danger because your house is on fire, but sometimes they are just too sensitive and go off when you're just cooking toast!
Your amygdala can be just the same. When your amygdala perceives danger it tries to warn you to protect you from harm. These could be physical dangers, like a car speeding towards you, or internal thoughts and fears such as worrying about a new situation or how people will react to your awful new haircut. The problem with anxiety sometimes is that, just like real smoke alarms, it becomes too sensitive and tells you things are really scary when actually they're not. It can be a bit of a drama queen!
The Brainstem
The science bit:
The brainstem controls the body's level of arousal through the heart rate, respiration rate and body temperature. During times of danger, the brainstem puts us into fight or flight mode by increasing respiration rate (to get more oxygen into the body), increasing heart rate (to pump oxygenated blood more quickly around the body). At the same time, adrenal glands release hormones such as adrenaline and cortisol into the body to release energy and get it ready for action.
Older child and teen explanation: When your smoke alarm goes off it sets off your fight or flight response. This goes back to caveman days when you might be expected to be attacked by a bear so it readies your body for danger by flooding your body with chemicals to make you stronger and faster so you can either fight the bear or flee from it (run). Your brain doesn't know the difference between a bear attacking and you realising you've forgotten your homework, so it reacts in the same way for both stressful events.
This means when you get anxious or stressed and your amygdala alarm goes off you can either go into 'fight mode' and act a bit like a guard dog (barking/shouting, attacking people or things and feeling angry) to try and protect yourself, or you might go into 'flight mode' like a scared rabbit who will either run away or freeze (avoiding situations, literally running, procrastinating, being unable to speak).
Sometimes when your amygdala gets upset it has trouble controlling your emotions and this can be when you can act in a silly way, doing things you know you shouldn't do, saying things that will upset someone, breaking things etc.
The Hippocampus
The science bit:
The hippocampus is also part of the limbic system. It is involved in the formation of new memories and with learning and emotions. When a particular smell triggers a memory, that's because your hippocampus encoded them together. When just the thought of an occasion like Christmas gives you a sudden feeling of joy, that's because your hippocampus saved the memory of the day and entwined it with the emotions. When someone has PTSD, and a random bang makes them react as if they were back in the car accident which was the cause of it, that's because the memory has been linked so strongly to the emotion. The memory, or sensations that have been linked to it, can trigger your fight or flight response in order to get you ready to deal with potential danger.
Older child and teen explanation:
For older children and teens we compare the hippocampus to a filing cabinet where you store memories, but in each file, it doesn't just store the facts about what happened but it also stores the feelings that went along with it.
So, if the first time a child got onto the school bus he was tripped up and laughed at as he squeezed down the aisle to find a seat, he would store the experience of getting on the bus with the negative feelings as well as the facts. This means that the next morning as the child wakes and thinks about going to school his hippocampus might bring out the file about the experience on the bus and suddenly, seemingly without warning, he's filled with dread and anxiety.
It's only his brain's way of trying to help him avoid feeling that way again in the future but it can trigger his fight or flight response giving him stomach aches, headache, tense muscles, butterflies in the stomach, dry mouth etc as his brain tries to ready him for the 'danger' ahead.
The Prefrontal Cortex
The science bit:
The prefrontal cortex (PFC) is part of the frontal lobe and is responsible for regulating behaviour and planning activities such as how to act towards other people. It's part of the thinking part of the brain which is much more complex than the survival areas and therefore works more slowly. During times of danger, it is bypassed and signals are sent instead to the survival part of the brain.
When you go into the fight or flight response the brain wants to act quickly (in case you're about to be eaten by that bear) so activity in the thinking part of the brain is reduced making it hard to think clearly while anxious. As the PFC has a part to play in regulating emotions when your child is in fight or flight mode then it is difficult for them to think and reason so they need to calm down first before you can talk to them about the problem.
Older child and teen explanation:
The prefrontal cortex helps to control your emotions and helps you think about how you interact with other people. Because it's quite a slow, complicated part of the brain when you go into fight or flight mode it gets disconnected - you don't want to be considering what type of bear is attacking you; how fast it's running; whether it looks cuddly or not etc when you really should be acting quickly in order to not get eaten!
This isn't very helpful if you're about to go into an exam - as you get nervous your brain disconnects!
Because it also regulates your emotions it also means that if someone is rude to you and that makes you anxious your thinking brain flicks off and no longer regulates your emotions or how you act towards others so you might end up hitting or swearing at them (fight) or running away or being unable to speak (flight).
The good thing is that you can do some simple breathing techniques and learn other tools to keep yourself calm so your PFC doesn't disconnect and keeps you in control.
Ways to calm your anxiety:
Breathing:
Hot Chocolate Breathing- hold your hands in front of you as if it were a cup of hot chocolate. Breathe in through your nose to smell the hot chocolate, blow out through your mouth to cool it. Perhaps even practise with real hot chocolate to start with, or use whatever yummy smelling food or drink you love.
4-4 breathing - breathe in for the count of 4, hold for 4, breathe out for 4. Repeat at least 4 times
Exercise: when you're in fight or flight mode your body is hyped up to deal with danger so it really helps to get rid of that energy and those hormones such as adrenaline and cortisol. If you make your body believe it's dealt with the threat by running or fighting then it will feel safe to go back into relaxed mode.
Distract yourself:
Look around yourself and try and spot as many things as you can that are purple, or that start with the letter T. By distracting your brain from worrying thoughts you can stop anxiety spiralling.
Mindfully eating chocolate (or your favourite food) - take a moment to explore a food or drink with all your senses - what does it look like, smell like, feel like, taste like. Take your time and really enjoy it
Talk to someone:
Pet
Friend
Parent (really? ugh)
Childline
or write it down and throw it away
If you are worried about your child or teen, talk to your GP or school.
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