4 November 2025

Mental Health and Anxiety in Children

By Karen Archer, Educational Psychologist and Deputy Principal at Bellavsita School

The World Health Organization (WHO) estimates that one in seven children and adolescents (ages 10-19) worldwide lives with a mental health condition, with anxiety disorders being among the most common conditions alongside depression and behavioural disorders.

What is Anxiety?

At its heart, anxiety is a feeling of worry, fear, or dread that can be difficult to control. It’s also a normal and useful emotion – a little anxiety sharpens our focus before an exam or gives us energy for a sports match. In fact, anxiety is part of our natural survival system. If you were suddenly in danger, the anxious response in your body – a faster heartbeat, quick breathing, sharper senses - could essentially be lifesaving.

However, when anxiety is not temporary and becomes overwhelming, it stops being protective and starts interfering with everyday life. One of the hardest parts for many, is the judgement around anxiety. Many people are taught to believe that they shouldn’t feel anxious and this shame only increases the stress and worry. Instead, we need to help children see that anxiety doesn’t define in them; it doesn’t make them bad or weak. When children learn to notice and name their anxiety, they begin to take back control. Far from making anxiety worse, this awareness gives the child the confidence and belief that they can cope. Remind your child: “Feelings come and go. You felt different before, and you’ll feel different again.”

As parents and educators, we need to be able to separate developmentally appropriate fears and everyday worries from an actual anxiety disorder. Here are some common signs of anxiety to watch out for in children:

• Psychological: constant worry, racing or obsessive thoughts.
• Behavioural: irritability, clinginess, crying, withdrawal, difficulty concentrating, sleep or eating changes.
• Physical: stomach cramps, nausea, diarrhoea, headaches, sweating, tense muscles, racing heart, or tingling hands.

What is happening in the brain when anxiety takes over?

Multiple parts of the brain are involved in thinking and learning. Firstly, the prefrontal cortex helps us concentrate, control our impulses, and think flexibly. Another key part of the brain is the amygdala, which processes emotions like fear. Normally, the prefrontal cortex keeps the amygdala calm, evaluating whether something is truly dangerous. However, when a harmless situation misinterpreted as a threat, the amygdala sounds the alarm, and the body goes into fight, flight, freeze, or fawn mode. 

When anxiety levels increase, it is almost impossible to ignore one’s fears and this interferes with the executive functioning of the brain. This is why anxious children can’t simply be told, ‘Don’t worry, it’s not that bad.’ Their brains and bodies are convinced the threat is real.

What Parents Can Do

Supporting a child with anxiety starts with us, the key adults in their world. Here are some simple, practical tips that work for the whole family: 

1. Connect Before You Correct: An anxious or upset child can’t access rational thinking. Stay calm, connect with them, and once they feel safe, then guide them. Psychiatrist Bruce Perry calls this Regulate, Relate, Reason. It is vital that we, as the parents or educator, learn to co-regulate ourselves. Start by asking yourself a few key questions such as: How do I react in moments of stress? What is my understanding and relationship with anxiety? Am I exacerbating my child’s anxiety in any way? Do I need to seek support first, before I can help my child? 
2. Lay the Foundations: Make sure the basics are in place: Sleep, Education, Exercise, Diet, and Socialisation. These are the building blocks of mental health.
3. Avoid Avoiding: Avoidance may bring temporary relief, but it feeds anxiety in the long run. Encourage your child to face fears gradually, with support.
4. Externalise the Worry: Give the anxiety a name, such as the “Worry Monster.” This separates the feeling from who the child is as a whole and becomes a common enemy in the house. It is something more tangible and does not define them. They feel more empowered and in control: ‘I don’t have to do what the Worry Monster says.’
5. Grounding Exercises
   Because anxiety is future-focused, grounding helps children come back to the present moment. A few examples are:

• The 3-3-3 Rule: Name three things you see, three things you hear, and three ways to move your body.
• The Colour Game: Choose a colour and name or find everything in the room with that colour.
• Barefoot Break: Let your child walk barefoot outside, noticing the ground under their feet while taking deep breaths.
• Breathwork: Teach slow, steady breathing (there are many examples online that you can do with your child). 

Final Word for Parents

Anxiety is not the enemy - it’s a normal and welcome human emotion. Regulating emotions is a skill that children learn when they are supported by an adult and when we as the key adult co-regulate, children develop the metacognitive skills to regulate themselves. With patience, strategies, and support, we can teach children that the goal isn’t to eliminate anxiety but to help children manage it, build resilience, and believe: ‘I can feel anxious and still be okay.’ For additional resources, visit www.bellavista.org.za