Anxiety in children and teenagers

What is anxiety in children and teenagers?

Some worry and fear is a normal, healthy part of growing up. Anxiety becomes a problem when it is strong, lasts a long time, and stops a child doing everyday things, such as going to school, seeing friends, sleeping, or being apart from a parent.

Anxiety in children and teenagers can show in different ways: constant worry, panic attacks, intense shyness or fear of social situations, separation anxiety, specific fears, or physical signs like tummy aches, headaches and trouble sleeping. Younger children may become clingy, tearful or have meltdowns rather than say they feel anxious.

The good news is that anxiety responds well to the right help. The first-line treatment for children and young people is talking therapy, usually cognitive behavioural therapy (CBT), which gradually helps a young person face feared situations and manage worried thoughts. Medication is not the first step; for some young people it may be added under specialist care.

Treatment aims to shrink anxiety back to a manageable size so a young person can get on with life, not to remove every worry, which would not be realistic or healthy.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Options at a glance

These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.

Preparing for your treatment

• If a young person is in crisis or unsafe, treat that first with 999 or A&E; therapy is not for emergencies.
• Start with the GP, who can assess, support and refer to therapy or CAMHS.
• Note what the anxiety stops your child doing, how long it has lasted, and what makes it better or worse.
• List physical symptoms (tummy aches, headaches, sleep) and any medicines or other professionals involved.
• Involve your child in a way that suits their age; CBT works best when they are on board.
• Avoid accidentally feeding anxiety by removing every challenge; gentle, supported steps help more.
• Think about practical support at school, especially for social anxiety or school avoidance.

What happens

Treatment begins with understanding the anxiety: what type it is, how much it affects daily life, what else is going on, and whether there are any safety concerns. Mild, recent anxiety may respond to guided self-help, digital CBT, or simple support and reassurance at home and school.

Where anxiety is more significant, talking therapy is the mainstay. Cognitive behavioural therapy helps a young person understand the worry cycle, face feared situations gradually (called exposure), and learn to manage anxious thoughts and physical feelings. For social anxiety, NICE recommends CBT, either one to one or in a group with others of a similar age. Parents are often involved, especially for younger children.

Medication is not first-line for anxiety in young people. For some, particularly with severe anxiety or where therapy alone is not enough, a child and adolescent psychiatrist may consider an SSRI alongside therapy, with careful monitoring, including for any early increase in agitation or thoughts of self-harm.

Progress comes from practice between sessions, not just the sessions themselves. The plan is reviewed and adjusted, and support at home and school helps a young person put new skills to work.

Is this treatment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

The main pitfall is avoiding feared situations, which feels kind but makes anxiety stronger over time; good treatment gently reverses this with support. If medication is used, the key safety point is close monitoring for any early increase in agitation or suicidal thoughts. Ask how progress is measured and what to do if anxiety worsens.

Published figures to discuss

Precise success or harm percentages for an individual young person would be misleading, because outcomes depend on the type and severity of anxiety, what else is going on, and how consistently therapy skills are practised. The clear safety point is that, if an SSRI is used, a small number of young people can have an early increase in agitation or suicidal thoughts, which is why monitoring is close. A short-term rise in anxiety when first facing feared situations is expected and is part of effective therapy, not a sign it is failing.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is no physical recovery. 'Afterwards' means gradually facing feared situations with new skills, the early weeks of any medication, and reviews that keep treatment on track.

• A temporary rise in anxiety when first facing avoided situations
• Gradual, uneven progress with better and harder days
• Tiredness after challenging sessions or steps
• Some mild, settling side effects in the first weeks of any medication

Aftercare

• Keep practising therapy skills and gentle exposure between sessions; this is where most progress happens.
• Avoid the trap of removing every challenge; support your child to face fears in small steps.
• If medication is prescribed, take it as directed, never stop suddenly, and report any early increase in agitation or self-harm thoughts.
• Support good sleep, routine and activity, which all help anxiety.
• Work with school on practical support, especially for social anxiety or school avoidance.
• Keep crisis numbers handy: 999 or A&E for a life-threatening emergency anywhere in the UK. For urgent mental-health support, in England, Scotland or Wales call 111 and choose the mental-health option; in Northern Ireland call Lifeline on 0808 808 8000, or contact your GP out-of-hours service. Other help: Samaritans 116 123, Papyrus HOPELINE247 0800 068 4141, or text SHOUT to 85258.
• Praise effort and courage, not just outcomes.

• Therapy appointments and home practice planned
• A few small, agreed steps to face feared situations
• Medication routine clear, with no sudden stopping
• Warning signs to watch for agreed
• Crisis numbers saved in phones
• School aware of agreed support
• Review appointments booked

⚠ Get urgent help if…

• Any talk of suicide, feeling hopeless, or wanting to escape life: call 999 or go to A&E now
• A new or increasing urge to self-harm, especially after starting or changing medication
• Becoming much more agitated or restless soon after starting an SSRI
• Anxiety so severe the young person cannot eat, sleep or leave the house at all
• Complete school refusal or total withdrawal from friends and activities
• Panic attacks that are frightening, frequent, or mistaken for physical illness
• For urgent but non-emergency mental-health support: in England, Scotland or Wales call 111 and choose the mental-health option; in Northern Ireland call Lifeline on 0808 808 8000 or your GP out-of-hours service. You can also contact Samaritans 116 123, Papyrus HOPELINE247 0800 068 4141, or text SHOUT to 85258

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your psychiatrist gives you.

Results & realistic expectations

With the right help, most children and teenagers with anxiety improve, often a lot. A good outcome is anxiety shrinking back to a manageable size, a return to school and activities, and a young person who has skills to handle worry in future.

Treatment does not remove every worry, and some anxiety is normal and healthy. Anxiety can also flare again at stressful times, so part of recovery is learning to recognise it early and use the skills that helped before. CBT aims to give lasting tools rather than a one-off fix.

Anxiety can settle well, but it can return at times of change or stress, such as exams, new schools, or family difficulties. The skills learned in therapy stay useful and can be brushed up if needed. A young person who knows their early warning signs and has a plan to seek help copes better with future episodes. Support and any medication are reviewed as they grow.

Related tests, treatments or support

Anxiety often overlaps with low mood, sleep problems, or other difficulties, and treatment may address these together. It can also coexist with neurodevelopmental differences such as autism or ADHD, where anxiety is common and support may need adapting. Where both therapy and medication are used, they work alongside each other and lifestyle support.

Follow-up & long-term care

Young people are reviewed to check progress, safety and any side effects. If medication is used, monitoring is closer early on. As anxiety improves, therapy is usually stepped down with a plan to maintain gains, and clear advice on when and how to seek help again.

• Keep using CBT skills and facing situations rather than avoiding them
• Brush up skills at known stressful times, such as exams or transitions
• Continue and review any medication as advised, never stopping abruptly
• Maintain sleep, routine and activity
• Have a plan to recognise and act on early warning signs

Repeat, follow-on and what comes next

• If the first approach does not help enough, the plan is reviewed and changed.
• Therapy intensity, format (individual or group) and any medication may be adjusted.
• Anxiety can return at stressful times, so a plan to re-engage and brush up skills is part of care.
• Care is reviewed as a young person grows and may transfer to adult services.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• Regular review of progress, safety and any side effects
• A clear home-practice plan, since most progress happens between sessions
• A named contact and crisis numbers for out of hours
• School liaison and practical adjustments where helpful
• A maintenance plan to keep gains and recognise early warning signs, with family support

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Type and number of therapy sessions and the therapist's training
• Individual versus group CBT
• Whether care is therapy-only or also involves a psychiatrist for medication
• The depth of initial assessment and any reports
• Whether family sessions or school liaison are included
• Treatment of any coexisting difficulties, such as low mood or sleep problems

• The therapist's qualifications and experience with young people
• Which therapy is recommended, how many sessions, and at what frequency
• Whether sessions are individual or group, and whether family is involved
• Whether a psychiatrist is involved if medication may be needed
• What monitoring and review are included, especially early in any medication
• How urgent concerns are handled out of hours
• Cancellation policy and what happens if more sessions are needed

On the NHS? Assessment and treatment for anxiety in young people are available on the NHS through GPs and CAMHS; private therapy may be used for choice or speed, with the same therapy-first approach.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the psychiatrist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the psychiatrist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good psychiatrist will welcome every one of these.

• What type of anxiety does my child have, and which therapy do you recommend?
• How is CBT delivered, and how much home practice is involved?
• How will we know if treatment is working, and when would you change the plan?
• If medication is considered, what are the benefits, side effects and monitoring?
• What support can school provide, especially for social anxiety or school avoidance?
• What should we do if anxiety gets much worse, especially out of hours?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the psychiatrist who carries out my treatment, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this treatment not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified psychiatrist for anxiety in children and teenagers

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NICE CG159 — Social anxiety disorder: treatment for children and young people NHS — Anxiety disorders in children YoungMinds — Anxiety: a guide for parents Papyrus — HOPELINE247 (0800 068 4141) Samaritans — call 116 123 free, any time nidirect — urgent and emergency care (Northern Ireland) nidirect — GP out-of-hours service NHS England — 111 mental-health crisis support NHS inform Scotland — urgent mental-health help NHS 111 Wales — mental health and wellbeing nidirect — mental health emergency (Lifeline crisis support)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.