Anxiety & Worry

Anxiety is the feeling that something bad might happen. Everyone has it, and it is useful: it makes us prepare, check, and take care. Children feel it about new places, being away from you, the dark, tests, friendships, getting things wrong — and what they worry about changes as they grow.

NHS guidance draws the line not by how strong a worry looks but by how much it is getting in the way. Worry that passes, and does not stop a child taking part, is ordinary. Worry that keeps coming back, is out of proportion to the situation, and is affecting sleep, school, friendships or family life is the kind worth doing something about.

Younger children often show anxiety in their bodies and their behaviour rather than their words: tummy aches, clinginess, not wanting to be left, sleep that comes apart, tears at the school gate. As children get older, worries become more social and more future-focused — being judged, getting it wrong, being left out, something happening to you.

Many children cannot say "I feel anxious". They say they feel sick, or that school is boring, or they get cross. That is not avoidance of the truth; it is the vocabulary and self-awareness they have so far.

• Physical: tummy aches, headaches, feeling sick, needing the loo often — most common before the thing they are worried about.
• Sleep: taking a long time to settle, waking, wanting company, bad dreams.
• Avoidance: not wanting to go somewhere, dropping a club, refusing an activity they used to enjoy.
• Reassurance-seeking: the same question again and again, and your answer not sticking for long.
• Irritability or outbursts, particularly at home after school.
• Difficulty concentrating, or a sudden drop in what they can manage.
• Being unusually careful, perfectionist, or upset by mistakes.
• Sunday evenings and the start of terms being noticeably harder.

Two things, in particular, quietly grow anxiety even though both come from love. The first is avoidance: when a child avoids the thing they fear, the relief is immediate, and the fear grows a little stronger for next time. The second is heavy reassurance: answering the same worry repeatedly gives short-term comfort but teaches the child that the worry needed answering.

This does not mean pushing a child into things or refusing to talk. It means aiming, over time, for small steps forward rather than either avoidance or confrontation — and for conversations that build the child's own thinking rather than settle the worry for them.

Anxiety about school is common, and mornings can become the worst part of the week for a whole family. Sometimes it is about a specific thing — a lesson, a lunchtime, a friendship, a walk down a corridor — and sometimes the child cannot say. Either way, working out what part of the day is hardest is more useful than treating school as a single object.

DfE guidance for schools on mental health issues affecting attendance is clear that these situations usually need support and adjustment alongside the expectation of attending, rather than enforcement alone. It is reasonable to ask school for a plan: a named adult, a soft start, a place to go, a check on the parts of the day that are hardest.

• Promising something you cannot guarantee ("nothing bad will happen").
• Long, logical arguments about why the worry is unrealistic — anxiety is not usually persuaded.
• Making the worry the main subject of family life.
• Removing everything difficult, or removing nothing.
• Treating breathing exercises or an app as the whole plan.
• Assuming that because school reports no problems, nothing is happening.
• Diagnosing at home, or online.

You do not need to wait for things to be severe. It is worth asking for advice when the worry is persistent rather than passing, when it is happening in more than one part of life, when your child is very distressed, when sleep, eating, friendships or school attendance are affected, or when family life has started to organise itself around the anxiety.

• Start with your child's teacher or the school's SENDCO — describe what you see and ask what they see.
• Your GP can advise and, where appropriate, refer to local children and young people's mental health services.
• Many areas have school-based mental health support teams, school counselling or early help; school can tell you what exists locally.
• NHS pages on anxiety in children set out common signs and what to do next.

1. NHSProfessional guidance
   Anxiety in children — advice for parents

   The plainest UK statement of the distinction this guide rests on: all children feel worried sometimes, and anxiety becomes a concern when it is out of proportion, persistent, and getting in the way of ordinary life.

2. NHSProfessional guidance
   Anxiety disorders in children

   Describes recognised anxiety difficulties and the routes to help — GP first, then local children and young people's mental health services. Diagnosis sits here, not with schools.

3. NHSProfessional guidance
   Children and young people's mental health — advice for parents

   The parent-facing hub, including what to do first and where support exists locally.

4. National Institute for Health and Care ExcellenceProfessional guidance
   Social, emotional and mental wellbeing in primary and secondary education (NG223) (2022)

   Recommends a whole-school approach: supportive climate, trusted relationships, universal curriculum content, targeted support for those who need more, and staff training to deliver it.

5. National Institute for Health and Care ExcellenceProfessional guidance
   Social anxiety disorder: recognition, assessment and treatment (CG159) (2013)

   Clinical guidance covering children and young people. Referenced here only to be clear where the clinical threshold and treatment decisions sit — with health services.

6. Department for EducationProfessional guidance
   Mental health and behaviour in schools (2018)

   Non-statutory advice on the line between what a school can reasonably provide and what needs a clinical service — the question most often at issue with anxiety.

7. Department for EducationProfessional guidance
   Mental health issues affecting a pupil's attendance: guidance for schools (2023)

   Directly addresses anxiety-related absence: attendance is usually improved by support and adjustment alongside expectation, rather than enforcement alone.

8. Department for EducationStatutory guidance
   Working together to improve school attendance (2022, statutory from 2024)

   Sets out the 'support first' expectation and the duties schools and local authorities hold where attendance is affected by health or SEND.

9. Department for EducationStatutory guidance
   SEND Code of Practice: 0 to 25 years (2015)

   Names anxiety as an example of a social, emotional and mental health need, and sets out the graduated approach — assess, plan, do, review.

10. Department for Education (research by University College London)Research evidence
    Identifying and supporting children and young people with social, emotional and mental health needs: a rapid evidence review (2025)

    Part of the DfE's SEND evidence programme. Published as research; the DfE states it does not endorse the approaches described.

11. Education Endowment FoundationResearch summary
    Improving Social and Emotional Learning in Primary Schools — guidance report (2019, updated 2021)

    Recommends teaching social and emotional skills explicitly and using them across the day. Rated by the EEF as moderate impact for very low cost, on moderate evidence.

12. Public Health England / Department for EducationProfessional guidance
    Promoting children and young people's mental health and wellbeing: a whole-school and whole-college approach (2021)

    The eight-principle framework most UK schools audit their wellbeing provision against.

13. Anna FreudProfessional guidance
    Mentally Healthy Schools

    Quality-assured UK resource bank for primary schools — useful when choosing classroom materials that are not simply commercial products.